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THE 



Compend of Anatomy. 



FOR USE IN THE DISSECTING ROOM, 



PREPARING FOR EXAMINATIONS. 



'£ 



JOHN B. BOBEKTS, A.M., M.D., 

LECTURER ON ANATOMY AND ON OPERATIVE SURGERY IN THE PHILADELPHIA 
SCHOOL OF ANATOMY, LATE DEMONSTRATOR OF ANATOMY IN THE PHILA- 
DELPHIA DENTAL COLLEGE, FELLOW OF THE PHILADELPH [A ACADEMY 
OF SURGERY, FELLOW OF THE AMERICAN SURGICAL ASSOCIATION, 
ETC. 



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PHILADELPHIA^^: Of wash\^ g 



C. C. BOBERTS & COMPANY, 

1118 Arch Street. 
1882. 



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Copyright 188.2, 
BY JOHN B. ROBERTS, M.D. 



WM. F. FELL & CO., 

Electrotypers and Printers, 

1220-1224 Sansom St. 



TO 

YxtUn gingham §tate*t£ f 

WHO HAS PEESONALLY 

ASSISTED IN THE LITEEAEY WOEK OP THE AUTHOR, 

FEOM HIS 

EARLIEST SCHOOL-DATS TO THE 

PEESENT TIME, 

THIS LITTLE VOLUME 

IS 

AFFECTIONATELY IN3CEIBED 

BY 

HER SON. 



CONTENTS. 



CHAPTER I. 



BOXES. 



PAGE 

Bones 11 

Spinal column 12 

Skull 14 

Cranium 14 

Face 19 

Sutures ... 23 

Fontanelles! 23 

Wormian bones 23 

Foramina of skull 24 



PAGE 

Fissures of skull 25 

Fossae of skull 25 

Hyoidbone 26 

Thorax 27 

Upper extremity 28 

Pelvis . 33 

Lower extremity 36 

Sesamoid bones 40 

Centres of ossification... 41 



CHAPTER II. 



ARTICULATIONS AND LIGAMENTS. 



Articulations 47 

Ligaments of trunk and 
head 47 



Ligaments of upper ex- 
tremity 50 

Of lower extremity 52 



CHAPTER III. 



Muscles 55 

Of cranium and face 57 

Of neck 62 

Triangles of neck 63 

Muscles of back 68 

Of abdomen 72 

Of thorax 72 

Of diaphragmatic region 73 

Of perineal region 73 



Of upper extremity 74 

Of shoulder and arm 74 

Of forearm 77 

Ofhand . 79 

f lower extremity 81 

Of thigh 82 

Of leg 85 

Of foot 86 



CONTENTS. 



CHAPTER IV. 



VASCULAR SYSTEM. 



PAGE 

Vascular system 89 

Arteries 90 

Aorta 90, 97 

Of head and neck 91 

Of upper extremity 94 

Of trunk 97 

Of lower extremity 99 

Pulmonary artery 101 

Veins , 101 



PAGE 

Pulmonary veins 101 

Systemic veins 102 

Veins of head and neck. 102 

Veins of upper extremity 107 

Veins of spine 110 

Veins of lower extremity 110 

Portal system 113 

Cardiac veins 114 

Lymphatics....'. 115 



CHAPTER V. 



NERVOUS SYSTEM. 



Nervous system 117 

Cerebro- spinal system... 118 
Spinal membranes and 

cord 118, 119 

Brain and membranes... 121 

Cranial nerves 132 

Sympathetic ganglia con- 
nected with 5th nerve. 141 



Spinal nerves 142 

Cervical nerves 142 

Dorsal nerves 145 

Lumbar nerves 145 

Sacral nerves 146 

Coccygeal nerve 147 

Sympathetic system 148 



CHAPTER VI. 



ORGANS OF DIGESTION. 



Mouth and teeth 152 Stomach 



Palate 154 

Salivary glands 154 

Pharynx and ctsophagus 155 

Abdomen 155 

Peritoneum... 156 



158 



Small intestine 159 

Large intestine 160 

Liver 162 

Pancreas 163 

Spleen 164 



CHAPTER VII. 

ORGANS OF CIRCULATION AND RESPIRATION. 



Thorax 165 

Circulatory organs 165 

Pericardium and heart... 165 

Foetal circulation 168 

Vocal and respiratory 
organs 169 



Larynx 169 

Trachea 171 

Lungs and pleural sacs.. 172 

Mediastinal space 173 

Thyroid and thymus 

glands 174 



CONTENTS. 



CHAPTER VIII. 

URINARY AND GENITAL ORGANS. 



PAGE 

Urinary organs 175 

Kidneys 175 

Supra-renal capsules 176 

Bladder 177 

Urethra 178 

Male genital organs 179 

Prostate and Cowper's 
glands 179 



PAGE 

Penis 179 

Testicles, scrotum and 

seminal vesicles 180 

Female genital organs... 182 

Vulva 182 

Uterus and appendages. 183 
Mammary glands 185 



CHAPTER IX. 



ORGANS OF SENSE. 



Skin 186 

Tongue 187 

Nose 188 



Eye 189 

Appendages of eye 192 

Ear 193 



PREFACE TO SECOND EDITION. 



The rapid sale of the first edition of The Compend of 
Anatomy and the favor, with which it has been received 
by students in all parts of the country, seem to show that 
it fulfils the purpose for which it was written. I therefore 
venture to offer a second revised edition within a few months 
after the publication of the first. A table of ossific centres 
has been added at the end of the chapter on Bones, and a 
number of alterations and improvements have been made 
where considered advisable. The size and general appear- 
ance of the book remain unchanged. 
April, 1S81. J. B. R. 



PREFACE TO FIRST EDITION. 



The Compend of Anatomy makes no pretensions to being 
a treatise on Anatomy, but is a concise statement of what is 
deemed essential to the student in following the lectures of 
myself, or other teachers of Human Anatomy. It will also 
be of use to those working in the dissecting room, or pre- 
paring for examinations. As a rule, I have accepted the 
statements and general arrangement of Gray, in order that 
it may be used in connection with his most valuable work ; 
but frequent reference has also been made to other anatom- 
ical authorities, such as Holden, Heath, and Flower; and 
some of the descriptions have been taken from the structures 
themselves. My own students will recognize in the present- 
ation of many subjects much that is familiar to them in my 
annual courses of lectures at the Philadelphia School of 
Anatomy, since I have adopted the method that experience 
there has shown to be most convenient to me, and most 
beneficial to them. The necessary conciseness has prevented 
long desertions, and indulgence is asked, if unimportant 
details seem, to some, to be passed over with too great ra- 
pidity. As a rule, Latin terms have been substituted by the 
appropriate English names; though in some cases the Latin 
termination or word has been retained, because a transla- 
tion or change in termination would so alter the appearance 
of the word that the student might fail to recognize the iden- 
tity. In other cases the old name has become anglicised, 
and is, therefore, retained with descriptive English adjec- 
tives ; as for example, the greater posterior rectus muscle of 
the head. This is more easily recollected by many than its 
equivalent, rectus capitis posticus major. My thanks are due 
to Dr. H. Augustus Wilson and Mr. Henry E. Everett, for 
assistance in certain parts of the work. 

1118 Arch Street, Philadelphia, 

October, 1880, J. B. E. 



THE COMPEND OF ANATOMY. 



CHAPTER I. 



THE BONES. 

The skeleton is the framework of the body, and consists 
of bones, whose function is to give support and protection 
to the organs, and to afford leverage for the action of the 
muscles. 

Structure of Bone. — Compact or ivory-like, and can- 
cellated or spongy. The former is usually upon the surface, 
the latter in the interior. Under the microscope we see 
Haversian canals for passage of vessels; from these radiate 
the canaliculi. Around the canals the lacunae are arranged 
in lamellae ; it is supposed that each lacuna contains a 
nucleated cell. Larger spaces exist, in addition to the 
Haversian canals, called Haversian spaces, and are for 
supplying the bone with blood elements. Bones are covered 
by a fibrous membrane called the periosteum, and, if they 
have a medullary canal, have a somewhat similar lining 
membrane, denominated the internal periosteum or medul- 
lary membrane. The canal in the interior of long bones 
and some of the larger Haversian canals contain marrow. 
Marrow is of two kinds — red, found especially in young 
bones, and yellow, found particularly in long adult bones. 
The latter is in composition principally fat. Bones receive 
blood supply by means of arteries and veins, which enter 
and make their exit by minute openings over the surface, 
by large apertures at the ends of bones and by the nutrient 
canal. 

Composition.— Gelatin and other organic material one- 
third ; calcium salts and other inorganic matter two-thirds. 

Development. — Intra-cartilaginous as in long bones ; in- 
tra-membranous as in bones of skull. 

Number of Bones in the skeleton varies with age of indi- 
vidual, because various segments coalesce, as for example 

11 



12 COMPEXD OF ANATOMY. 

the sacrum and coccyx, as age increases. In the adult 
there are 200, if the hyoid and the two patellae are included , 

Spinal column 26 

Head 

Cranium 8 

Face 14 

Sternum and Ribs 25 

Hyoid 1 

Upper extremities 64 

Lower extremities 62 

Total 200 

The teeth are not bones 5 the ossicles of the ear and the 
sesamoid bones are not counted. 

Varieties — 1, long, as humerus; 2, short, as carpal 
bones ; 3, flat, as occipital and ribs ; 4, irregular, as 
vertebrae and sphenoid. 

SPINAL COLUMN. 

The spine is composed of 24 true and 9 false vertebrae ; 
the latter forming the sacrum, composed of 5 segments, and 
the coccyx, formed of four segments. A vertebra is com- 
posed of a body, and laminae projecting backwards, to form 
the vertebral canal for the spinal cord, and uniting at the 
spinous process. The laminae are attached to the body by 
the pedicle ; and upon the laminae are found two transverse 
and four articular processes. Above and below the pedicles 
are the intervertebral notches for the exit of the spinal 
nerves. The true vertebrae are divided into regions as 
follows: 7 cervical, 12 dorsal and 5 lumbar. The skull also 
is composed of modified vertebrae. 

The cervical vertebrae are distinguished by lateral lips on 
upper surface of body, anterior lip on lower surface, bind 
transverse processes with foramen for vertebral artery, vein 
and nerves,, and bifid spinous process. The first cervical, or 
atlas, is peculiar because it has no body, no spinous process 
and is composed of two arches and lateral masses ; the 
second, or axis, is peculiar because of odontoid process, 
which passes up between the two lateral masses of the atlas 
to form a pivot upon which atlas and skull rotate. The 
odontoid process is really the body of the atlas soldered 
upon the top of the body of the axis. The seventh cervical 
has a long spinous process which is not bifid. 



VOXE^. 13 

The dorsal vertebras are distinguished by half facets on 
body for beads of ribs, and whole facets on transverse pro- 
cesses for tubercles of ribs. Spinous processes are long and 
overlap each other. The peculiar dorsal are the first with a 
whole facet above and a half facet below on the body, the 
ninth with a half facet above, the tenth with a whole facet, 
the eleventh with a whole facet on body but none on trans- 
verse process, and, the twelfth with a whole facet on body 
none on transverse process and inferior articular processes 
resembling lumbar vertebrae. 

The lumbar vertebras have large oval bodies, long trans- 
verse processes, and strong square-looking spines. The 
fifth lumbar is peculiar because of short transverse process 
and obliquity of lower surface of body. 

Development of Vertebrje. — By three primary centres, 
one for the body and one for each lamina. There are also 
secondary centres, and some variations in the ossification of 
the peculiar vertebrae. 

The sacrum is a triangular bone with base towards lumbar 
vertebrae and apex towards coccyx. Observe following 
points: on anterior surface, horizontal ridges showing union 
of the five false vertebrae, the anterior sacral foramina, the 
lateral masses due to the coalescing of the transverse pro- 
cesses, the promontory, and the alae ; on posterior surface, 
the rudimentary spines, the articulating processes, the pos- 
terior sacral foramina, the rudimentary transverse processes, 
the spinal canal, and the cornu on each side for articulation 
with the coccyx ; on the lateral surface, the auricular surface 
for articulation with ilium ; on the base, the articular surface 
for the last lumbar vertebrae, and the sacral canal ; at the 
apex the facet for the coccyx. 

Developed by union of five vertebrae, and has 35 ossific 
centres. Articulates with fifth lumbar vertebra, two in- 
nominate bones and coccyx. Principal muscles attached 
to it are Pyriformis, Coccygeus, Great gluteal, Broad dor- 
sal, and Erector of spine. 

Peculiarities of Female Sacrum. — It is wider, less 
curved from above downwards, and inclines more obliquely 
backwards than the male. 

The coccyx is formed of four rudimentary vertebrae. Ob- 
serve the cornu and the rudimentary transverse process on 
each side. Developed by four centres, one for each segment. 
The principal muscles attached are the Coccygeus, Great 
gluteal, Sphincter of the anus and Elevator of the anus. 



14 COMPEND OF ANATOMY. 

SKULL. 



Composed of Cranium, 8 bones 



Face, 14 bones 



Total 22 bones. 



Occipital. 

Two Parietal. 

Frontal. 

Two Temporal. 

Sphenoid. 

Ethmoid. 

Two Nasal. 

Two Superior* Maxillary. 

Two Lachrymal. 

Two Malar. 

Two Palate. 

Two Inferior Turbinated 

Vomer. 

Inferior Maxillary. 



CRANIUM. 

The cranial bones consist of an outer and an inner table 
of compact tissue, between which is situated cancellous 
structure, called in this region diploe 

Occipital. — External surface presents external protuber- 
ance, crest, superior and inferior curved lines ; condyles j 
foramen magnum for cord and membranes, vertebral arteries 
and spinal accessory nerves ; tubercles for check ligaments ; 
the' basilar proces and pharyngeal spine ; jugular processes ; 
anterior condyloid foramina for hypoglossal nerves ; and 
occasionally posterior condyloid foramen for a small vein to 
lateral sinus. Internal surface shows fossae for cerebrum 
and cerebellum ; internal protuberance ; grooves for torcular 
Herophili, superior longitudinal, lateral and occipital sinus- 
es ; ridges for falx cerebri, falx cerebelli and tentorium cere- 
belli ; internal openings of foramen magnum and anterior 
condyloid foramina ; jugular fossa in front of jugular process, 
on the latter of which is seen the groove for the end of the 
lateral sinus, and sometimes the orifice of the posterior con- 
dyloid foramen. On the basilar process in front of the 
foramen magnum is a smooth surface upon which lies the 
medulla oblongata. The occipital, from its superior to its 
lateral angles, articulates with the parietals, forming the 
lambdoidal suture ; from the lateral to the inferior angle 
with the temporal ; while the basilar process, representing 
the inferior angle, unites with the body of the sphenoid ; 



BOXES. 15 

the condyles articulate with the atlas. The bone nas four 
centres of ossification, for posterior, basilar, and each con- 
dyloid portion. It gives attachment to the following mus- 
cles : Occipitofrontal, Trapezius, and Sterno-mastoid to 
superior curved line ; the Cornplexus, Splenius of head and 
Superior oblique to the space between the curved lines ; 
Greater and Lesser posterior rectus muscles behind the 
foramen magnum ; the Greater and Lesser anterior rectus 
muscles in front of this opening, the Lateral rectus mus- 
cles at the sides of this same foramen on the jugular pro- 
cesses ; and the Superior constrictor of the pharynx to the 
pharyngeal spine. 

Parietal. — On the external surface the following jDoints 
are to be examined ; the parietal foramen, the parietal emi- 
nence, and the temporal ridge for the attachment of the 
temporal fascia. The inner surface is grooved at its upper 
border by the superior longitudinal sinus, at the lower pos- 
terior angle by the lateral sinus, and at the lower anterior 
angle by the middle meningeal artery. Near the groove for 
the longitudinal sinus are seen the depressions for the Pac- 
chionian bodies. The superior border articulates with the 
bone of the opposite side, forming the sagittal suture ; the 
anterior border with the frontal bone, constituting part of 
the coronal suture ; the posterior border with the occipital, 
and the inferior border with the sphenoid anteriorly and the 
temporal throughout the rest of its extent. It is developed 
from one centre. The Temporal muscle is the only one 
attached to the parietal bone. 

Froxtal. — It consists of a vertical portion and a hori- 
zontal portion. The vertical portion presents upon its ex- 
ternal surface the remains of the frontal suture, the frontal 
eminence, superciliary ridge, supra-orbital arch, supra- 
orbital notch or foramen, external and internal angular pro- 
cesses, nasal eminence, nasal notch and spine, and begin- 
ning of the temporal ridge. On the internal surface of the 
vertical portion are seen the groove for the superior longi- 
tudinal sinus, with the ridges for the falx cerebri ; the frontal 
crest j and the foramen caecum, which is sometimes incom- 
plete. There are spaces between the two plates of the 
vertical portion, called frontal* sinuses, communicating with 
the anterior ethmoid cells and middle meatus of the nose 
by means of the infundibulum on each side. The horizontal 
portion consists of the thin orbital plates, separated by the 
ethmoidal notch ; these orbital plates show on their lower 



1G COMPEND OF ANATOMY. 

aspect the fossa for the lachrymal gland, and the point of 
attachment of the pulley for the Superior oblique muscle. 
The edges of the ethmoidal notch present several half cells, 
completed when the ethmoid bone is articulated with the 
frontal, and two grooves, similarly completed, called the 
anterior and posterior ethmoidal canals. The internal sur- 
face of the orbital plates has no important landmarks upon 
it. The frontal articulates with the parietal, sphenoid, eth- 
moid, nasal, superior maxillary, lachrymal and malar. The 
muscles attached to it are the Corrugator of the eyebrow, 
Orbicular of eyelids, and Temporal. It is developed by two 
ossific centres. 

Temporal. — It consists of three parts, squamous, mas- 
toid, and petrous. The squamous on its outer surface pre- 
sents grooves for the deep temporal arteries, and the zygo- 
matic process extending forward to articulate with the malar 
bone ; at the base of this process are seen the tubercle, and 
the articular eminence ; behind it the glenoid fossa for ar- 
ticula ion with the condyle of the lower jaw bone and for 
the parotid gland, the Grlaserian fissure for the passage of 
the Laxator tympani muscle, and the vaginal process. In 
the angle between the squamous and petrous portions, and 
parallel to this fissure, can be seen the canal of Huguier for 
the chorda tympani nerve. The inner surface of the squam- 
ous portion is grooved by the middle meningeal artery. 
The mastoid portion contains in its interior cells, and pre- 
sents on its external aspect the mastoid foramen, digastric 
fossa and occipital groove j and on the internal, a deep 
groove for the lateral sinus. The petrous portion has a 
pyramidal form, and hence presents a base, an apex, three 
surfaces and three borders. It contains the organ of hear- 
ing. The base and apex are each perforated by a large 
opening, the former by the external auditory meatus, sur- 
rounded by the auditory process of bone, the latter by t T ie 
internal or cerebral opening of the carotid canal. On the 
posterior surface of the petrous portion there are two import- 
ant points to be remembered, on the anterior three, and on 
the inferior four. 

Posterior. — Internal auditory meatus, for facial and au- 
ditory nerves. 

Aqueduct of the vestibule, for small vessels. 
Anterior. — Elevation over superior semicircular canal. 

Hiatus Fallopii, for greater petrosal nerve. 



BONES. 17 

Depression for Casserian ganglion of trifacial 
nerve. 
Inferior. — Lower opening of carotid canal. 
Jugnlar fossa. 
Styloid process, for three muscles and two 

ligaments. 
Styloid-mastoid foramen, for facial nerve. 
There are four less important points on the inferior sur- 
face : 1, the aqueduct of the cochlea $ 2, the canal for 
Jacobson's nerve (tympanic branch of glosso-pharyngeal), 
lying between the carotid canal and the jugular fossa ; 3, the 
canal for Arnold's nerve (auricular branch of pneumogas- 
tric), lying in the jugular fossa ; and 4, the auricular fissure, 
between the vaginal and mastoid processes, for the exit of 
this same Arnold's nerve. 

The anterior border of the petrous bone is unimportant; 
the superior is grooved for the superior petrosal sinus, the 
inferior, at its inner .part, for the inferior petrosal sinus. 
The tentorium cerebelli is attached to the upper border. 
In the reentrant angle between the petrous and squamous 
portions are the orifices of two canals leading into the tym- 
panum ; one for the Eustachian tube, and above it that for 
the passage of the Tensor of tympanum muscle. They are 
separated by the cochleariform process. The aqueduct of 
Fallopius is the canal between the internal meatus and the 
stylo-mastoid foramen. 

The temporal bone is developed by four centres, for the 
squamous, the petrous and mastoid, the styloid, and auditory 
processes respectively. It articulates with the occipital, 
parietal, sphenoid, malar and inferior maxillary. The prin- 
cipal muscles attached to it are — ■ 

Squamous... Temporal, Masseter. 

Mastoid Occipito-frontal, Sterno-mastoid, Tra- 

chelo-mastoid, Splenitis of head, Di- 
gastric. 
Styloid Process... Stylo -pharyngeus, Stylo-hyoid, Stylo- 
glossus. 
Petrous Elevator of palate, Tensor of tympanum. 

Sphenoid. — This bone resembles a bat with outstretched 
wings. It presents for consideration a body, two large and 
two small wings, and the pterygoid processes (legs of the 
bat). The superior surface of the bone shows in front the 
ethmoidal spine, projecting from the front of the lesser 



18 COMPEND OF ANATOMY. 

wings, with grooves for the olfactory nerves on each side; 
immediately behind is the optic groove leading to the optic 
foramina ; then the olivary process, behind which is the 
sella Turcica for the petuitary body. On each side of the 
sella Turcica are seen the three clinoid processes, while 
posteriorly are situated the surface supporting the medulla 
oblongata, and the articular surface for the basilar process 
of the occipital bone. Along each side of the body of the 
sphenoid lies the groove for the cavernous sinus; and be- 
tween the two wings the sphenoidal fissure, or anterior 
lacerated foramen, is situated. At the root of the greater 
wing are seen two openings, the round foramen running 
forward for the superior maxillary division, and the oval 
foramen downward for inferior maxillary division, of the 
fifth nerve. The spinous process, perforated by the spinous 
foramen, projects backward from the great wing. 

The antero inferior surface of the bone presents the verti- 
cal lamella and rostrum for articulation with the ethmoid 
and vomer, and the openings of the sphenoid sinus partially 
covered by the sphenoidal turbinated processes. On the 
inner side of the base of the pterygoid process is seen a 
small aperture called the pterygo-palatine canal, and still 
nearer the median line of the body of the bone the vaginal 
process, articulating with the edge of the vomer. Perforat- 
ing the base of the pterygoid process is the Vidian canal, 
and above it externally the anterior opening of the round 
foramen. 

The pterygoid process consists of an internal and external 
plate with the pterygoid notch between. The internal termi- 
nates in the hook, or hamular process, for the tendon of the 
Tensor of palate muscle. The scaphoid fossa lies at the base 
of the internal plate on its posterior aspect. The greater 
wing has three surfaces, the cerebral, the orbital, and the 
external, divided by the pterygoid ridge into two parts. 
The upper portion of this surface has the Temporal, and the 
lower the External pterygoid muscle attached. The lesser 
wing is a thin plate, fitting into the fissure of Sylvius of the 
brain, and forming the upper boundary of the anterior 
lacerated foramen. 

The sphenoid is developed from ten ossific centres : for 
lesser wings, 2 ; for greater wings, 2 ; for internal pterygoid 
plates, 2; for body, 2; for sphenoidal turbinated process, 2. 
It articulates with occipital, parietal, frontal, temporal, eth- 
moid, malar, palate and vomer. The muscles attached are 



BOXES. 19 

the Temporal, External and Internal pterygoid, the muscles 
of the orbit except the Inferior oblique, Superior constrictor 
of the pharynx, Tensor of palate and Laxator tjmpani. 

Ethmoid. — The organ of smell is contained in this bone, 
which resembles the letter T, with a lateral mass hanging 
from each half of the horizontal portion of the letter. The 
horizontal plate of the bone lies between the orbital plates 
of the frontal ; and is perforated with holes for the branches 
of the olfactory nerve, and for the exit of the na c al branch 
of the ophthalmic nerve, which has entered the cranial cav- 
ity, from the orbit, by the anterior ethmoidal foramen. The 
horizontal plate is called the sieve-like or cribriform plate. 
Projecting upwards is the crista galli for the attachment of 
the falx cerebri. The perpendicular, or vertical plate, of 
the bone forms a portion of the septum between the nasal 
cavities. The lateral masses, consisting of numerous cells 
and half cells, form part of the inner wall of the orbit, and 
of the outer wall of nasal cavities. The surface of the lat- 
eral masses presenting towards the orbit is smooth, and is 
designated the os planum; the surface towards the nose 
shows two scroll-shaped processes called the superior and 
middle turbinated bones, or processes, of the ethmoid. From 
the lower edge of the os planum projects the unciform pro- 
cess, to assist in closing the antrum of the superior maxilla. 
In the anterior part of the lateral mass of each side is a canal 
called the infundibulum, leading from the anterior ethmoid 
and frontal sinuses to the middle meatus of the nose. This 
bone is formed from three centres, one for each lateral mass 
and one for the vertical plate. It articulates with the frontal, 
sphenoid, nasal, superior maxillary, lachrymal, palate, infe- 
rior turbinated, vomer, and also with the triangular cartilage 
of the nose. No muscles are attached to it. 

FACE. 

Nasal. — There is nothing of special importance about 
this bone, except the crest on its internal surface at the 
inner edge, and the groove on this same surface for the 
nasal nerve. It is developed from one centre, and articulates 
with the frontal, ethmoid, superior maxillary and opposite 
nasal. No muscles are attached to it. 

Superior Maxillary. — The body of this bone is made 
hollow by the maxillary sinus, or antrum of High more, 
which opens into the middle meatus of the nose. It sup- 
ports four processes ; the malar, nasal, alveolar for the 



20 COMPEND OF ANATOMY. 

sockets of the upper teeth, and the palatine or roof of the 
mouth. It enters into the formation of the orbit, the nose 
and the mouth. The anterior, or facial surface, presents 
the incisive and canine fossae, separated by the canine emi- 
nence, the infra orbital foramen, and a part of the lower 
margin of the orbit. The posterior surface is marked by 
the posterior dental canals, the maxillary tuberosity and 
half of the posterior palatine canal. The orbital, or supe- 
rior surface, forms part of the floor of the orbit, and is 
grooved by the infra-orbital canal. The internal, or nasal 
surface, shows, above the palate process, the opening of the 
antrum, half the lachrymal duct, the inferior turbinated 
crest for the inferior turbinated bone, and above this, on the 
nasal process, the superior turbinated crest for the middle 
turbinated bone. Below the crests lie the inferior and mid- 
dle meatuses of the nose. The antrum has its orifice much 
diminished, when the bones are articulated, by the ethmoid, 
inferior turbinated and palate bones. The malar process 
joins the maxillary process of the malar bone ; the nasal 
process ascends alongside of the nasal bone, and is grooved 
by half of the lachrymal duct. The alveolar process has 
eight cavities for the two incisors, one canine, two bicuspid, 
and three molar teeth, The palate process constitutes a 
great portion of the roof of the mouth, and of the floor of 
the nose ; it is perforated by the anterior palatine canal, and 
in front projects to form the anterior nasal spine. The bone 
is developed by four centres ; facial, orbital and malar, 
palate, and incisive. It articulates with frontal, ethmoid, 
nasal, malar, lachrymal, inferior turbinated, palate, vomer 
and the other superior maxillary. The muscles of import- 
ance attached to it are, Orbicular of eye^ds, Elevator of the 
upper lip, Elevator of the lip and nose, Elevator of the angle 
of mouth, Masseter, Buccinator, and Orbicular of mouth. 

Lachrymal. — This shows the lachrymal groove for the 
lachrymal sac, is developed by a single centre, and articu- 
lates with frontal, ethmoid, superior maxillary and inferior 
turbinated. The Tensor tarsi has its origin from this bone. 

Malar. — The cheekbone has frontal, zygomatic, maxillary 
and orbital processes, and is perforated by the temporo- 
malar canals. It is formed from one ossific centre, and 
articulates with frontal, sphenoid, temporal and superior 
maxillary. The muscular attachments are Elevator of the 
upper lip, Greater and Lesser zygomatics, Masseter and 
Temporal. 



bo::es. 21 

Palate. — This bone is shaped like the letter L, having a 
vertical and a horizontal plate. The horizontal plate forms 
the back part of the hard palate, and therefore serves as 
the floor of the nose in the posterior part of that cavity. 
Its anterior edge articulates with the palate process of the 
upper jaw bone, its internal with the opposite palate bone, 
its external joins the vertical plate, while the posterior is 
free for the attachment of the soft or muscular palate. In 
the middle line the two plates unite to form the posterior 
nasal spine. The vertical plate, on its nasal surface, pre- 
sents the inferior and superior turbinated crests for the in- 
ferior and middle turbinated bones, resembling in this re- 
spect the inner surface of the superior maxilla. Below these 
crests are seen the inferior and middle meatuses of the nose. 
The anterior part of this plate is prolonged as the maxillary 
process, which covers part of the opening of the antrum; at 
the back part is seen the posterior palatine canal. At the 
junction of the two plates posteriorly is situated the tuber- 
osity, or the pterygoid process, of the palate, which fits into 
the notch between the two pterygoid plates of the sphenoid. 
The middle portion of the vertical plate presents the sphe- 
noidal process, at the base of which is the spheno-palatine 
foramen separating it from the orbital process above. Th : s 
consists of a five-sided process containing a cavity or sinus 
in its interior. The surfaces are named maxillary, sphe- 
noidal, and ethmoidal, because they articulate with these 
bones ; and orbital and zygomatic, because looking toward 
these cavities. The palate is formed from one centre, and 
articulates with sphenoid, ethmoid, superior maxillary, in- 
ferior turbinated, vomer and opposite palate. The Azygos 
uvulae, Tensor of palate, Internal and External pterygoid and 
Superior constrictor of the pharynx are attached to it. 

Interior Turbinated. — This facial bone lies within the 
nasal fossa, and is scroll- shaped, or curled. It has a lach- 
rymal, a maxillary and an ethmoid process, and is developed 
by a single centre of ossification, and articulates with the 
lachrymal, superior maxillary, ethmoid and palate. It is 
covered by the nasal mucous membrane. 

Vomer. — The bony septum of the nose is formed to a great 
extent by this bone, which has been called the plough-share 
or vomer. Its base has two alas, or wings, which articulate 
upon the sides of the roctruni of the sphenoid ; along each 
side of the bone is a groove or canal for the naso palatine 
nerve. The articulations are with the sphenoid, ethmoid, 



22 COMPEND OF ANATOMY. 

two superior maxillary and two palate bones, and with the 
triangular cartilage of the nose. 

Inferior Maxillary. — The lower jaw bone is really two 
bones united at the chin, and hence each half is symmetrical. 
It carries the lower teeth which correspond in name and 
number with those of the upper jaw, formed of the two 
superior maxillary bones. The inferior maxilla is composed 
of the body, or horizontal horse-shoe shaped portion, and a 
perpendicular portion, or ramus, on each side. The body 
presents in front the mental process and the symphysis ; 
and laterally the incisive fossa, the mental foramen, the ex- 
ternal oblique line and the groove for the facial artery. On 
the inner surface of the body are seen the genial tubercles, 
fossa for the sublingual gland, depression for Digastric 
muscle, internal oblique line, or mylo-hyoid ridge, and fossa 
for submaxillary gland. The alveolar border of the body 
contains the sockets for the tee^h. 

In the child there are on each side, 2 incisors, 1 canine, 
3 molars ; in the adult, 2 incisors, 1 canine, 2 bicuspids and 
3 molars. The ramus, or vertical portion has at its upper 
border the condyloid process, for articulation with the gle- 
noid cavity of the temporal bone, the corono'd process, for 
the attachment of the Temporal muscle, and the sigmoid 
notch between. On its internal aspect are seen the aper- 
ture of the inferior dental canal, the mylo-hyoid groove for 
the vessels and nerve of that name, and the spine for the 
internal lateral ligament of the temporo-maxillary joint. 
The angle of the jaw to which the stylo-maxillary ligament 
is fastened, is made by the junction of the ramus and body. 
The lower jaw is developed by two lateral ossific centres, 
and articulates on each side with the temporal bone. 
Many muscles are fastened to this bone. 

^Elevator and Depressor of lower lip. 
Muscles of J Depressor of angle of mouth, 
Lips, ] Platysma myoid, 

Orbicular of mouth. 
' Buccinator, 
Masseter, 

Internal and External pterygoid, 
Muscles of Temporal, 
Mastication. "] Digastric, 

Genio-hyoid, 
Mylo-hyoid, 
_ Geni-hyo-glossus. 



BOSES. 23 

Certain changes in the shape of the lower jaw occur dur- 
ing the various periods of life. These are due to the fact 
that when the full number of permanent teeth are in posi- 
tion the alveolar process must be deep, to support them 
firmly.. Hence, in infancy and old age the mental foramen 
is near the upper edge of the body, because there is no 
marked alveolar process. In the same way, the angle made 
by the axis of the ramus and the axis of the body is obtuse, 
because the jaws are not separated by the teeth. In adult 
life the alveolar process is high in both jaws, and the bone 
shows nearly a right angle between body and ramus. 

SUTURES. 

The lines of articulation of the bones of the head are called 
sutures, which are named from the bones forming them. 
Thus the junction of the parietal and temporal bones consti- 
tutes the parieto-temporal suture. Certain important sutures 
have received specific names which must be remembered. 
The Sagittal Suture is the Inter-parietal. 

" Coronal " " Fronto- parietal. 

" Lambdoidal* ; " Occipitoparietal. 

11 Basilar u tl Occipito-sphenoidal. 

11 Transverse " li Fronto-facial. 
The transverse extends across the upper part of the face and 
the orbit, being the articulation of the frontal with the malar, 
sphenoid, ethmoid, lachrymal, superior maxillary and nasal 
bones. 

The existence of these su f ures must be remembered in 
examining the skull in suspected fracture. 

FOXTAXELLES. 

The fontanelles are openings in the infant's skull situated 
between the angles of the parietal and the adjacent cranial 
bones. They are occupied with unossified membrane, which 
soon after birth becomes bony. There are six such open- 
ings, two in the median line, called anterior and posterior, 
and two lateral ones on each side. The fontanelles are im- 
portant in obstetric practice. 

WORMIAN BOXES. 

Spaces in the cranium, which remain unossified by the 
ordinary ossific centres, have at times special bony centres 
developed, which then form small irregular bones. These, 
from their three-cornered shape, are often called ossa tri- 
quetra. The term Wormian bone is generally preferred. 



24 COMPEND OF ANATOMY. 

FORAMINA OR OPENINGS OF THE SKULL. 

Foramen Ccecitm Vein. 

Cribriform Openings.. Olfactory and nasal nerves. 

Anterior Ethmoid Anterior ethmoid vessels, nasal 

nerve. 

Posterior Ethmoid Posterior ethmoid vessels. 

Optic Optie nerve, ophthalmic artery. 

Anterior Lacerated, or 

Sphenoidal Fissure. Third, fourth, ophthalmic division 
of fifth, and sixth nerves ; oph- 
thalmic vein. 

Round Superior maxillary division of fifth 

nerve. 

Oval Inferior maxillary division of fifth 

nerve, small meningeal artery 
and small petrosal nerve. 

Spinous Middle meningeal artery. 

Of Vesalius Vein. 

Middle Lacerated Filled with fibro- cartilage ; Vidian 

nerve crosses it above. 

Carotid Internal carotid artery, carotid 

plexus of the sympathetic nerve. 

Hiatus of Fallopius... Great petrosal nerve. 

Internal Auditory 

Meatus Facial and auditory nerves, auditory 

artery. 

Aqueduct of Vestibule Small artery and vein. 

Posterior Lacerated or 

Jugular Glosso-pharyngeal, pneumogastric 

and spinal accessory nerves in 
front ; internal jugular vein, men- 
ingeal branches of occipital and 
of ascending pharyngeal arteries 
behind. 

Anterior Condyloid... Hypoglossal nerve. 

Posterior Condyloid... Vein. 

Great (Foramen 

Magnum) Medulla oblongata and membranes, 

both spinal accessory nerves, both 
vertebral arteries. 

Mastoid Vein and artery. 

Anterior Palatine Anterior palatine vessels, naso-pala- 

tine nerves. 



BOXES. 25 

Posterior Palatine Posterior palatine vessels and pala- 
tine nerves. 

Ptery go- Palatine Pterygopalatine vessels. 

Eustachian Eustachian tube. 

Of Tensor Tympani... Tensor Tympani muscle. 

Vidian Vidian nerve. 

Glascrian Fissure Laxator Tympani muscle, tympanic 

artery, processus gracilis of 
malleus. 

Canal of Huguier Chorda tympani nerve. 

Jacobson's Tympanic branch of glossopharyn- 
geal nerve. 

Arnold's Auricular branch of pneumogastric 

nerve. 

Aqueduct of Cochlea.. Vein. 

Stylo- Mastoid Facial nerves, stylo-mastoid artery. 

Aqueduct of Fallopius Facial nerve. 

Supra-orbital Supra-orbital artery and nerve. 

Infra- orbital Infra- orbital artery and nerve. 

Mental Mental artery and nerve. 

FISSURES. 

Sphenoidal Fissure... Same as anterior lacerated foramen. 

Spheno-maxillary In back of orbit between great sphe- 
noid wing and superior maxillary 
bone. Transmits superior max- 
illary nerve, infra- orbital artery, 
ascending nerves from Meckel's 
(spheno-palatine) ganglion. 

Ptery go-maxillary Between pterygoid process of sphe- 
noid and superior maxilla. Is at 
right angles to the spheno-max- 
illary. Transmits branches of in- 
ternal maxillary artery. 

FOSSAE. 

Anterior Lodges the frontal lobes of cerebrum. 

Middle Lodges the temporo- sphenoidal lobes 

of cerebrum. 
Posterior Lodges the cerebellum, pons Varolii 

and medulla oblongata. 
Temporal From temporal ridge to pterygoid 

ridge, inside of zygomatic arch. 



2G COMPEKD OF ANATOMY. 

Zygomatic Below zygoma and pterygoid ridge, 

between ramus of lower jaw and 
pterygoid process of sphenoid. 

Spheno- maxillary Triangular space beneath apex of 

orbit, at junction of spheno- 
maxillary and pterygo-maxillary 
fissures. Contains the spheno- 
palatine ganglion (Meckel's). 

Orbit Pyramidal cavity, the walls of which 

are made by frontal, sphenoid, 
ethmoid, superior maxilla, malar, 
lachrymal and palate. Contains 
eye, with its muscles, vessels, 
nerves, etc. 

Nasal Fossa? One on each side of middle line, and 

separated by the septum. Open 
on face by anterior nares (or 
nostrils), into pharynx by pos- 
terior nares. Formed by frontal, 
sphenoid, ethmoid, and all the 
bones of face except malar and 
• lower jaw. 

Septum formed principally by verti- 
cal plate of ethmoid, and the 
vomer. 
On outer wall find three passages or 
meatuses under the turbinated 
bones. 

Superior Meatus Under superior turbinated (process 

of ethmoid). 
Into it open sphenoid and posterior 
ethmoid cells and sphenopala- 
tine foramen. 

Middle Meatus Under middle turbinated (process of 

ethmoid). 
Into it open frontal and anterior 
ethmoid cells by infundibulum, 
and antrum. 

Inferior Meatus Under inferior turbinated bone. 

Into it opens nasal duct. 

HYOID, OR LINGUAL BONE. 

This bone is shaped like a horse shoe, and has a body 
with a greater and a lesser cornu, or horn, on each dde. It 



BOXES. 27 

supports the base of the tongue, and is developed by five 
centres, one for the body, and one for each horn. The 
principal muscles attached are as follows : 

Sterno- 



Thyro- 

Omo- 

Stylo- 

Mylo- 

Genio- 



Genio-hyo-glossus. 
Hyo-glossus. 
i . •, Middle constrictor of pharynx. 

► fcyoid Tendon of Digastric. 



The following ligaments are inserted into it : stylo-hyoid, 
thyro-hoid, and hyo- epiglottic. 

THORAX. 

The chest cavity, or thorax, contains the heart and lungs, 
and is formed by the dorsal vertebras, the ribs, with their 
cartilages, and the sternum. 

Sternum. — It consists of three segments; the manubrium 
or handle, the gladiolus or sword, and the ensiform or xi- 
phoid appendix. The manubrium, or upper piece, presents 
a facet on each side for the clavicle, one for the first costal 
cartilage, and a half facet for the second costal cartilage. 
On its upper border is the interclavicular notch. The 
second segment is marked by transverse lines, showing that 
it is developed by different ossific centres, and on its lateral 
borders are seen facets for the cartilages of the ribs. There 
are four complete facets on each side, and a half one at the 
upper and lower angles. These facets are situated at the 
lines of junction of the various bony centres, similar to the 
costo-vertebral articulations. The ensiform appendix is the 
thin semi- cartilaginous lower extremity of the sternum, and 
has a half facet at its base for the seventh costal cartilage. 
There is, sometimes, a foramen in the lower part of the 
sternum. It is developed by six primary centres, one for 
the manubrium, one for the ensiform appendix, and four for 
the central segment. Occasionally, there are pairs of ossific 
centres for one or more segments, and then a foramen may 
exist by imperfect coalescing of these bony nuclei. Articu- 
lates with clavicles and seven costal cartilages. Muscles 
attached are, Sterno-mastoid, Sterno-hyoid, Sterno-thyroid, 
Greater pectoral, Triangular of sternum, Diaphragm, and 
aponeurosis of Abdominal muscles. 

Ribs. — There are twelve on each side. The seven upper 
ones are true ribs, while the remaining five are called false. 



28 COMPEXD 07 ANATOMY. 

The seven connected with the sternum by their own carti- 
lages are denominated vertebro- sternal ribs; the three (8th, 
9th, 10th), attached to the sternum indirectly by means of 
their own cartilages articulating with the cartilages of those 
above, are called vertebro-costal (or vertebro- chondral) ; the 
last two are floating, or vertebral ribs. A rib has a shaft, or 
body, and two extremities. The posterior, or vertebral end, 
consists of a head, neck, and tuberosity. Observe the 
double facet on the head, for articulation with two adjacent 
vertebrae, and the ridge for the inter-articular ligament. 
The tuberosity presents a surface for articulation with the 
transverse process of the vertebra. The shaft has an angle, 
and a groove on the inside of the lower border, for the inter- 
costal artery and nerve. The anterior extremity is hollowed 
out to receive the cartilage. 

Peculiar Bibs. 
First, . . short, flat, no angle, single facet on head, tubercle 

separating two grooves for subclavian vessels. 
Second, . angle close to tuberosity, shaft not twisted. 
Tenth, . . single facet on head. 
Eleventh, single facet ; no tuberosity. 
Twelfth, . single facet ; no tuberosity ; no angle. 

The ribs are developed from three centres ; head, shaft, 
tubercle. Those that have no tubercle are ossified from two 
centies. The muscles attached to the ribs and cartilages 
are numerous : 

Pectorals (Greater and Lesser). 

Intercostals (External and Internal). 

Scalenes (Anterior, Middle and Posterior). 

Serratus (Great, Posterior superior, Posterior inferior). 

Abdominal muscles. 

Dorsal muscles (Latissimus dorsi; Sacro-lumbalis, etc). 

UPPER EXTREMITY. 

Clavicle, or Collar Bone. — The sternal end is cuboidal, 
and presents articular surfaces for sternum, and for first 
costal cartilage, and rough depression on lower surface for 
attachment of costo- clavicular (rhomboid) ligament. The 
outer, or acromial end is flattened, and is marked by facet 
for the articulation, and a tuberosity and oblique line on in- 
ferior aspect for coraco-clavicular (conoid and trapezoid) 
ligament. The shaft is curved, and on the lower surface has 
a groove for the Subclavius muscle. It is developed by a 



BONES. 29 

centre for the shaft, and one for the sternal end. The most 
important muscular attachments are : to inner half, Greater 
pectoral and Sterno-cleido-mastoid ; to outer half, Deltoid 
and Trapezius ; and underneath, Subclavius. 

Scapula. — This bone has an anterior surface, or venter ; 
a posterior surface, or dorsum 5 a posterior border or costa; 
an external, or axillary border ; an internal, or vertebral 
border ; a superior angle, an inferior angle, an external 
angle, or head j and two processes. The venter is almost 
entirely occupied by the subscapular fossa; the dorsum is 
divided by the spine into the supra-spinous and infra-spinous 
fossae. The spine begins at the vertebral costa, or border, 
by a smooth, triangular surface, and terminates in the acro- 
mion process. The acromion projects over the shoulder- 
joint, and has a facet for the clavicle. The superior borde.r 
of the scapula terminates, at the outer end, in the coracoid 
process, and has near the root of this process the supra- 
scapular notch for the passage of the supra-scapular nerve. 
The artery of this name passes above the transverse liga- 
ment, crossing the top of this notch. The external border 
is wide, for muscular origins, and above its middle is grooved 
for the dorsal artery of the scapula. The internal border, 
or base of the bone, is thin, and has numerous muscles 
attached to it. The superior and inferior angles have mus- 
cular attachments, and are unimportant. The external 
angle, or head of the bone, presents the glenoid cavity, or 
socket, for the head of the humerus ; and shows a constric- 
tion behind, called the neck. 

The scapula is developed by seven centres j one for body, 
two for coracoid process, two for acromion, one for posterior 
border, and one for inferior angle. The humerus and clav- 
icle articulate with it. The muscular attachments are im- 
portant, and may be stated as follows : — 

Venter Subscapular. 

Dorsum Supra-spinous, Infra-spinous. 

Spine Deltoid, Trapezius. 

Superior Border.. Omo-hyoid. 

Posterior Border. Great serratus, Elevator of angle of sca- 
pula, Greater and lesser rhomboid. 

External Border. Triceps, Greater and Lesser teres, Bi- 
ceps. 

Coracoid Biceps, Coraco-brachial, Lesser pectoral. 

Acromion Platysma myoid. 



30 COMPEND OF AX ATOMY. 

Humerus. — The upper extremity consists of a head, neck, 
and two tuberosities. The head is hemispherical, and artic- 
ulates with the glenoid cavity of the scapula ; around it is a 
constriction called the anatomical neck, separating the head 
from the tuberosities. Below the tuberosities is situated 
what has been called the surgical neck, though there is at 
that point no marked constriction. The greater tuberosity 
presents three facets for the insertions of the Supra spinous, 
Infra-spinous, and Lesser teres muscles ; the lesser has one 
facet for the Subscapular muscle. Between the tuberosities 
is the bicipital groove, bounded by the anterior and pos- 
terior bicipital ridges, and lodging the tendon of the long 
head of the Biceps and a branch of the anterior circumflex 
artery. The shaft presents on its posterior surface the 
musculo- spiral groove, for the musculo-spiral nerve and the 
superior profunda artery; near its middle is seen, on the 
outside, the rough surface for the insertion of the Deltoid, 
on the inner side, that for the Coraco-brachial muscle. 
Near the latter is the nutrient foramen for the passage of the 
nutrient vessels. The lower extremity is flattened antero- 
posteriorly, and presents the articular surface for the bones 
of the forearm. This is divided into the trochlear surface 
for the ulna, and the radial head of the humerus, so-called, 
for the radius ; above these surfaces, in front, are two de- 
pressions, into which the upper parts of these bones fit dur- 
ing extreme flexion, and which are called respectively the 
coronoid and the radial depressions. Behind, there is a 
single fossa, called the olecranon depression. At the sides 
of the articular surface are two tubercles, called condyles, 
of which the inner is the more prominent ; from these a ridge 
runs upwards on each side of the shaft, called the supra- 
condyloid ridge. 

The humerus is developed by seven centres, one each for 
shaft, head, greater tuberosity, radial head, trochlear sur- 
face, internal and external condyle ; and articulates with 
scapula, radius and ulna. 

Muscular Attachments. 

Greater Tuberosity Supra-spinous, Infra-spinous, Lesser 

teres. 

Lesser Tuberosity Subscapular. 

Shaft Greater pectoral, Latissimus dorsi. 

Greater teres, Deltoid, Coraco-bra- 
chial. 

Anterior brachial, Triceps. 



BOXES. 31 

Internal Condyle Ulnar flexor of wrist, Radial flexor 

of wrist. 
Superficial flexor of fingers. 
Round pronator of radius, Long 
palmar. 
External Condyle and 

Ridge Extensors and Supinators, 

viz. : Ulnar extensor of wrist. 
Long radial extensor of wrist. 
Short radial extensor of wrist. 
Common extensor of fingers. 
Extensor of little finger. 
Long supinator. 
Short supinator and anconeus. 
Ulna. — The upper extremity consists of two processes, a 
large posterior one called the olecranon, and a smaller one 
anteriorly, named the coronoid process. Between these is 
the greater sigmoid cavity for articulation with the humerus, 
and to the outside of them the lesser s : gmoid cavity for the 
head of the radius. The shaft is prismatic, and tapers toward 
the lower extremity, which consists of the head of the ulna 
and the styloid process. The head has, on its lateral sur- 
face, a facet for the radius ; on its inferior aspect, an artic- 
ular surface for the triangular cartilage, which separates 
the bone from the wrist-joint. The ulna is developed from 
a centre for the shaft, one for the olecranon and a third for 
the lower end. It articulates with the humerus and radius, 
but has no direct osseous articulation with the wrist bones. 
The attached muscles are important. 

Olecranon Triceps, Anconeus, Ulnar flexor of 

wrist. 

Coronoid Anterior brachial, Round pronator of 

radius. 
Superficial and Deep flexors of fingers. 
Long flexor of thumb. 

Shaft Deep flexor of fingers, Square pronator. 

Ulnar flexor of wrist, Ulnar extensor of 

wrist. 
Anconeus, Short supinator. 
Two Extensors of thumb (of metacarpal 

and of second phalanx). 
Extensor of index. 

" Radius. — The upper end consists of a head, neck, and 



32 COMPEND OF ANATOMY. 

tuberosity. The head has a shallow cup which articulates 
with the radial head of the humerus, an J. a smooth circular 
border that rotates in the lesser sigmoid cavity of the ulna. 
The shaft terminates below in a large extremity, which has 
a sigmoid cavity for the ulna, and a large concave surface 
for articulating with the carpus to form the wrist joint. The 
scaphoid and semilunar bones are the only carpal bones that 
articulate with the radius. The lower extremity of the 
radius has a styloid process, though it is not as prominent 
as that of the ulna. The lower end of the radius is grooved, 
on its posterior and external surface, for the tendons of the 
extensors ; all of which pass over it, except the Ulnar ex- 
tensor of the wrist, which has a groove for itself in the lower 
end of the ulna. The radius has a centre of ossification 
for the shafc, and one for each extremity, and articulates 
with the humerus, ulna, scaphoid and semilunar. The 
muscular attachments are as follows : — 

Tuberosity Biceps. 

Styloid Process Long supinator. 

Shaft Short supinator, Superficial flexor of 

fingers. 

Long flexor of thumb, Square pro- 
nator. 

Extensor of metacarpal of thumb. 

Extensor of first phalanx of thumb. 

Bound pronator of radius. 
Hand. — The hand is composed of the carpus of eight 
bones, the metacarpus of five, and the fourteen phalanges. 
The carpal bones are arranged in two rows of four each. 
Their names, from the radial towards the ulnar side, are — 
First Bow. — Scaphoid, semilunar, cuneiform, pisiform. 
Second Row. — Trapezium, trapezoid, magnum, unciform. 

The important points to remember about them are, that 
only the first two mentioned enter into the formation of the 
articulation with the forearm, and that the pisiform is very 
prominent at the base of the hand on the ulnar side, and 
may be mistaken for a tumor by the careless student. The 
metacarpal bones are five in number, one for each finger, 
and have a cuboidal base, a shaft and flattened head. They 
differ somewhat from each other, in regard to size and the 
existence of lateral articular facets at the base. The most 
important peculiar! l y is that the metacarpal of the thumb, 
in shape and in method of ossification, resembles a phalanx. 



There are fourteen phalanges, if the metacarpal of the thumb 
be still considered a metacarpal j otherwise, we count four 
metacarpals and fifteen phalanges. A phalanx has a base, 
a shaft, and a head composed of two small condyles, sepa- 
rated by a groove. The last, or ungual, phalanges have a 
rough oval surface for the support of the pulp of the finger 
tips. 

The carpal bones are developed from a single centre for 
each ; the metacarpals by two centres, one for the shaft and 
one for the head ; the phalanges by two centres, one for the 
shaft and the other for the base. The metacarpal of the 
thumb, however, is developed like a phalanx. The follow- 
ing muscular insertions are important: — 

Radial flexor of wrist, to base of metacarpal of index. 
Ulnar flexor of wrist, to base of metacarpal of little finger. 
Radial extensor of wrist (Long), to base of metacarpal of 

index. 
Radial extensor of wrist (Short), to base of metaoarpal of 

middle finger. 
Ulnar extensor of wrist, to base of metacarpal of little finger. 

PELVIS. 

The pelvis is formed by the two innominate bones, the sa- 
crum and the coccyx. The ilio-pectineal line divides the 
pelvis into the true and false pelvis. The upper, or false, is 
a large basin-like cavity between the iliac bones ; the lower, 
or true pelvis, has a cavity, an inlet or superior strait, and an 
outlet or inferior strait. When the trunk is erect the pelvis 
is placed obliquely, so that the axis of the superior strait is 
upwards and forwards. The female pelvis is less massive 
than the male, the iliac bones are further apart, the cavity is 
larger, the pubic arch wider, and the sacrum usually wider 
and less curved. 

The great sacro-sciatic foramen, formed by the notch of 
the same name, and the lesser sacro-sciatic ligament, trans- 
mits the Pyriformis muscle, the gluteal vessels and nerve, 
the sciatic vessels and nerves, and the internal pudic vessels 
and nerve. The lesser sacro-sciatic foramen, completed by 
both sciatic ligaments, transmits the Internal obturator mus- 
cle and allows the internal pudic vessels and nerve to re- 
enter the pelvis. 

Innominate Bone — Os Innominatum. — This bone in youth 
exists as three separate pieces, which at about the age of pu- 



o4 COMPEXD OF ANATOMY. 

berty unite to form one irregular bone. The three segments 
are called the ilium, ischium, and pubes : and it is usually 
more convenient to describe each of these separately than to 
attempt to take the innominate as a whole. 

The Ilium is the broad portion that forms the prominence 
of the hip, or haunch. The external surface, or dorsum, is 
crossed by the superior, middle, and inferior curved lines, 
which, starting at the great sacro-sciatic notch behind, radiate 
towards the upper edge, or the crest, of the ilium. The in- 
ternal surface presents the venter, or internal iliac fossa, and 
has at its lower border theilio-pectineal line. The posterior 
part of the internal surface exhibits the auricular surface, for 
articulation with the sacrum, and the rough space ior the 
attachment of ligaments. The upper border of the ilium is 
called the crest, and is convex ; while the anterior presents 
the anterior superior and inferior spinous processes, sepa- 
rated by a notch ; and the posterior, in a similar way, the two 
posterior spinous processes, separated by a notch. Below 
the posterior inferior spine is the great sacro-sciatic notch. 
Between the great sciatic notch and the anterior inferior 
spine, on the external aspect of the bone, is seen the portion 
of the acetabulum, or hip-joint cavity, which is formed from 
the ilium. About two-fifths, or a little less, of this cavity is 
formed from the ilium. 

The Ischium is divided into the body, tuberosity, and ra- 
mus. The body exhibits on its external surface the iscbiatie 
portion of the acetabulum, which constitutes a little more 
than two-fifths of the whole cavity. The internal surface 
of the body is separated from the iliac fossa by the ilio-pec- 
tineal line, and has at its posterior border the spine of the 
ischium. Above the spine is situated the greater, and below 
it, the lesser sacro-sciatic notch. In front of tbe body of 
the ischium lies the obturator, or thyroid foramen, with a 
groove running towards its upper part, for the vessels and 
nerve. The tuberosity of the ischium is a rough prominence 
for muscular attachments, upon which the trunk rests when 
in the sitting position. The surfaces for the muscles are well- 
marked. The ascending ramus, or simply the ramus, is the 
thin portion that projects upwards and forwards from the tu- 
berosity, and forms part of the circumference of the obtu- 
rator foramen. 

The Pubes is divisible into a body, a horizontal ramus, 
and a perpendicular ramus, though the direction of these 
portions can scarcely be called horizontal and perpendicular, 



BOXES. 35 

when the pelvic bones are articulated. The body is situated 
at the junction of the horizontal with the perpendicular ra- 
mus, and forms with the opposite bone the symphysis of the 
pubes. The upper and anterior coiner is called the angle of 
the pubes, from which the crest extends to the spine of the 
pubes, situated at the extremity of the ilio-pectineal line. 

The outer end of the horizontal ramus makes one-fifth of 
the acetabulum, or cotyloid, cavity ; the ilio-pectineal emi- 
nence, separating the ilium and pubes, lies just above the 
acetabulum. The ilio-pectineal line runs along the top of 
the ramus to the spine of the pubes. The descending, or 
perpendicular, ramus joins the ascending ramus of the is- 
chium, and completes the obturator foramen. The ramus 
of the pubes and that of the ischium, of the two sides, form 
the arch of the pubes, under which lies a portion of the ex- 
ternal genito-urinary apparatus. 

The acetabulum, or cotyloid cavity, is formed from the 
three sections of the innominate bone : the ilium forms less 
than two-fifths, the ischium more than two-fifths, and the 
pubes one-fifth. At the inner side of this cup-shaped cavity 
is the cotyloid notch for the entrance of vessels into the 
joint ; while at its bottom is a depression to which the round 
ligament of the femur is fastened. The obturator, or thy- 
roid, foramen is a large opening bounded by the pubic bone 
and ischium. It is closed by the obturator membrane, ex- 
cept at its upper and outer part, where an opening is left for 
the passage of the obturator vessels and nerve. 

The innominate bone is ossified by three primary and five 
secondary centres. The primary are for ilium, ischium and 
pubes ; the secondary are for crest, anterior inferior spine, 
tuberosity of ischium, symphysis, and a Y-shaped piece in 
the acetabulum, at junction of the three bones. It articulates 
with the sacrum, femur, and opposite innominate. The mus- 
cles attached are numerous and important. These are the 
ones necessary to remember: — 

Iliu^i. Crest External oblique, Tensor of 

sheath of thigh, Broad dor- 
sal. 
Internal oblique. 
Transversalis, Quadrate of 
loins, Erector of spine. 

Dorsum Three gluteals, Rectus. 

Venter Iliac. 

Anterior Spines. Sartorius, Rectus. 



36 COMPEXD OF ANATOMY. 

Ischium. Body External and Internal obturator 

Levator ani, Coccygeus, Su- 
perior gemellus. 

Tuberosity Three Ham-string Muscles, 

Quadrate of thigh, Great 
adductor, Inferior gemellus, 
Transverse of perineum, 
Erector of penis. 

Pubes External and Internal Oblique, 

Transvjrsalis, Rectus, Py- 
ramidalis, Small Psoas, Pec- 
tineus, Long and Short Ad- 
ductors, Gracilis, External 
and Internal Obturators, Le- 
vator Ani, Compressor of 
Urethra. 

LOWER EXTREMITY. 

Femur. — The upper end presents the head, neck, and 
greater and lesser trochanters ; which trochanters are con- 
nected by the anterior and posterior inter-trochanteric lines. 
The anterior inter-trochanteric line is sometimes called the 
spiral line. Behind and below the top of the greater tro- 
chanter is seen the digital fossa, while at the junction of its 
lower portion with the neck of the bone in front is seen the 
tubercle of the femur. The posterior inter-trochanteric line 
is marked, and has a rough ridge running downward from it, 
which is called the line for the quadrate muscle. The head 
of the bone has a small fossa for the round ligament. The 
lower extremity is divided into two large knobs, or condyles, 
separated by the inter- condyloid notch behind, rnd by the 
trochlear surface for the patella in front. Both condyles 
are smooth on the lower surface, for articulation with the 
tibia, but the inner condyle is rather longer than the outer. 
The outer condyle presents on its external surface a tuber- 
osity, and a depression and groove for the tendon of the 
Popliteus muscle, while on the inner condyle is seen the 
inner tuberosity and a tubercle for the insertion of the 
Great adductor. The shaft is smooth anteriorly ; but on i s 
posterior surface is seen the linea aspera, a rough ridge 
which bifurcates above and below. The upper lines into 
which it divides continue to the trochanters, the inner one 
running around in front of the lesser trochanter to join the 
anterior inter-trochanteric line. The lower ridges extend 



BONES. 37 

down to the condyles, leaving between them a triangular 
interval called the popliteal space, or ham. On the pos- 
terior surface of the femur above the condyles are the de- 
pressions from which the two heads of the Gastrocnemius 
arise. 

The femur articulates with the innominate bone, tibia and 
patella, and is developed by a centre for each of the follow- 
ing parts, making in all five — shaft, head, lower extremity, 
greater trochanter and lesser trochanter. The muscles 
attached to it are important. 

Great Trochanter Middle and small gluteals, Pyri- 

formis. 
Internal and External obturators, 

Quadrate of thigh. 
Superior and Inferior gemellus. 

Small Trochanter Great psoas, Iliac (just below it). 

Shaft Internal and External vast, Great 

gluteal, Biceps (short head), Pec- 
tineus, Long, Short and Great 
adductors, Crureus, Subcrureus. 

Condyles Gastrocnemius, Plantaris, Popliteus. 

Patella. — This is a large sesamoid bone developed in 
the tendon of the Four-headed extensor muscle of the leg. 
It is somewhat triangular, and presents on its posterior 
surface two facets for articulation with the condyles of the 
femur. The outer facet is the larger. The lower portion, 
or apex of the bone, has attached to it the ligament of the 
patella. The bone has one centre of ossification, which 
does not appear until after birth. It articulates with the 
femur, and has attached to its upper and lateral surface the 
four components of the Four-headed extensor, viz., Rectus, 
Crureus, External vast and Internal vast. 

Tibia. — The upper end, or head, is composed of the two 
tuberosities, external and internal, which have the upper 
articular surface smooth, to form wiih the condyles of the 
femur the knee-joint. Be' ween the articular surfaces is 
located the spine, with depressions in front and behind, for 
the attachments of the crucial ligaments and semi-lunar 
cartilages. Below the tuberosities in front is the tubercle, 
to which is attached the ligament of the patella, having 
between itself and the upper part of the tubercle a bursa. 
The posterior border of the inner tuberosity has a groove 
for the tendinous insertion of the Semi-membranous muscle; 
that of the outer one a facet for the head of the fibula. The 



38 COMPEND OF ANATOMY. 

shaft of the bone has three surfaces and three borders. The 
inner surface is principally subcutaneous, and at the upper 
part of the posterior surface is the oblique line. The ante- 
rior border is called the crest or shin, and the external, or 
interosseous, border gives attachment to the interosseous 
membrane. The lower extremity is prolonged on its inner 
aspect and forms the internal malleolus ; on its outer aspect 
is seen the ficet for the lower end of the fibula. The lower 
surface of the inferior end of the tibia and the external sur- 
face of the internal malleolus are smooth, for articulation 
with the astragalus. Behind this malleolus is a marked 
groove in which lie the tendons of the Posterior tibial and 
Long flexor of the toes. The tibia is developed by a centre 
for the shaft and one for each extremity ; and articulates 
with femur, fibula and astragalus. The attached muscles 
are : — ■ 

Inner Tuberosity Semi-membranous. 

Outer Tuberosity Anterior tibial, Long extensor of toes. 

Shaft Sartorius, Gracilis, Semi-tendinous, 

Anterior tibial, Popliteal, Soleus, 

Long flexor of toes, Posterior 

tibial. 
Tubercle Four-headed extensor of leg (by 

ligament of patella). 
Fibula. — The head, or upper extremity, has a facet for 
articulation with tibia, and a styloid process projecting up- 
wards. The lower end constitutes the external malleolus, 
and has on its inner aspect a smooth articular surface for 
the astragalus, above which is the surface for the triangular 
ligament holding it to the tibia. The shaft has three sur- 
faces and three borders ; the inner border is better called 
the interosseous ridge. The oblique line of the fibula begins 
at the inner side of the head, and at the lower part of the 
bone becomes continuous with the interosseous ridge. 
The bone is ossified by three centres, head, shaft, and lower 
end ; and articulates with tibia and astragalus. 

MUSCLES. 

Head Biceps, Soleus, Long Peroneal. 

Shaft Long extensor of toes, Extensor of 

great toe, Soleus, Posterior tibial, 
Long flexor of great toe, Long 
peroneal, Short peroneal, Third 
peroneal. 



BONES. 39 

Foot. — The bones of the foot are divided into three re- 
gions; tarsus, metatarsus, phalanges. 

Tarsus. — The tarsal bones are seven — calcaneum or os 
calcis, astragalus, cuboid, scaphoid, internal, middle and 
external cuneiform bones. The os calcis has on its upper 
surface two articular facets for the astragalus, and a groove 
for the interosseous ligament ; internally is a process called 
the sustentaculum, which supports the inner part of the 
astragalus. The inferior surface has two tubercles; the in- 
ternal surface is concave, allowing space fur the passage of 
tendons and other structures underneath the sustentaculum; 
and the external has a tubercle for a ligament. To the pos- 
terior surface is attached the tendon of Achilles, while the 
anterior articulates with the cuboid. The astragalus con- 
sists of a body, neck and head. The body articulates with 
tibia and fibula above and laterally, with os calcis under- 
neath, and ha^ a groove behind for the Long fiexor of great 
toe. Anterior to the body is the head, smooth for articula- 
tion with the scaphoid, and having behind it the constriction 
or neck of the bone. The scaphoid is concave behind for 
the head of the astragalus, and convex in front for articula- 
tion with the three cuneiform $ it has a tubercle for the Pos- 
terior tibial muscle. The cuboid presents nothing particular 
except the groove for the Long peroneal. The cuneiform 
are three in number ; internal, external and middle. The 
articulations of these bones are as follows : — 

Os Calcis with cuboid, astragalus. 

Astragalus " tibia, fibu'a, os calcis, scaphoid. 

Cuboid " os calcis, -external cuneiform, 

fourth and fifth metatarsal. 

Scaphoid " astragalus, the three cuneiform. 

Internal Cuneiform. u scaphoid, middle cuneiform, first 

and second metatarsal. 

Middle Cuneiform.* lt scaphoid, internal and external 

cuneiform, second metatarsal. 

External Cuneiform " scaphoid, middle cuneiform, cu- 
boid, second, third and fourth 
metatarsal. 

Metatarsus. — These five bones have each a base, shaft 
and head. The first has at its base a surface for the inser- 
tion of the Long peroneal tendon, and -at its head two sur- 
faces for two sesamoid bones $ the second is remarkable for 
the manner in which its base is wedged between the ex- 



40 COMPEKD OF ANATOMY. 

ternal and internal cuneiform bones ; and the fifth has a 
large tubercle at its base. 

Phalanges. — The phalanges resemble those of the hand, 
and are arranged in a similar manner, two for the great toe 
and three for each of the others. The ungual phalanges, 
namely: — the second of the first toe, and the thi-d of the 
other toes, have the irregular distal extremity for the pulp. 
The tarsal bones are developed by one centre in every in- 
stance, except the os calcis, which has an epiphysis, or 
separate centre, for its posterior extremity. The metatarsal 
bones, except the first, have a centre for the shaft and one 
for the digital extremity or head; the phalanges have a 
centre- for the shaft and one for the base. The first meta- 
tarsal is ossified like the phalanges, and is really to be con- 
sidered a phalanx, as is the first metacarpal of the hand. 

The principal muscular attachments of the foot are as fol- 
lows: — 

Os Calcis... Gastrocnemius, Soleus, Plantaris, 

Abductor of great toe, Abductor 
of little toe, Short extensor of 
toes, Short flexor of toes, Acces- 
sory flexor of toes. 
Internal Cuneiform. .. Anterior tibial, Posterior tibial. 

Metatarsal Interosseous, Long, Short and Third 

peroneals, Adductor of great toe, 
Short flexor of little toe, Anterior 
tibial. 

Phalanges Long and short extensors of toes, 

Long and Short flexors of toes ; 
Abductor, Adductor, Short flexor, 
Long flexor, and Extensor of great 
toe ; Short flexor and Abductor of 
little toe ; Interosseous ; Trans- 
verse of foot. 

SESAMOID BOXES. 

These are little nodules of bone found in tendons, which 
press very firmly upon the bony surfaces over which they 
glide. The patella is a large sesamoid bone; others are 
found in the Short flexor of the great toe, Short flexor of 
the thumb, etc. They are usually situated over joints, but 
not necessarily, for some occur where a tendon curves 
around a bone, as that in the Long peroneal as it lies in the 
groove of the cuboid. 



BONES. 
TABLE OF OSSIFIC CENTRES. 



41 



Vertebra. 



Atlas. 



Axis. 



7th Cervical. 



Lumbar 
Vertebras. 



Sacrum. 



CENTRES OF OSSIFICATION. 

SPINAL COLUMN. 

3 primary, 

2 for laminae. 

1 for body. 

4 secondary, 

2 for transverse process. 
2 for spinous process. 

2 additional 

for upper and lower sur- 
— faces of body. 

9 

2 for lateral masses. 
1 for anterior arch (some- 
— times absent.) 



2 for laminae. 

1 for body. 

2 for odontoid process. 

1 for apex of odontoid pro- 

— cess. 
6 

like other ordinary ver- 
tebrae, and in addition 2 
centres for anterior tu- 
bercles of transverse pro- 
cesses. 

like other vertebrae, but 2 
additional centres for tu- 
bercles on back of supe- 
rior articular processes 

5 for five vertebral bodies. 
10 for laminae of five vertebrae. 

6 for lateral masses. 

10 for upper and lower sur- 
faces of five vertebrae. 
4 for auricular surfaces and 
— sides of bone. 
35 



TIME OF APPEARANCE. 



6 weeks. 
2 months. 

16 years. 
16 years. 

21 years 



before birth. 
1 year. 



6 weeks. 
2 months. 
6 months. 



6 months. 



10 weeks. 

8 months. 

8 months. 
16 years. 

20 years. 



42 



COMPEND OF ANATOMY. 



Coccyx. 
Occipital. 

Parietal. 
Frontal. 
Temporal. 



Sphenoidal. 



Ethmoid. 



Nasal. 



CENTRES OF OSSIFICATION. TIME OF APPEARANCE. 

spinal column — Continued. 
4, one for each vertebral seg- 1st at birth. 

ment. 2d 5-10 years. 

3d 10-15 years. 

4th 15-20 years. 



SKULL. 



1 for occipital portion 

2 for condyloid i i 
1 for basilar l i 



1 at parietal eminence. 

2 for two lateral halves. 

1 for squamous and zygoma. 
1 f >r petrous and mastoid. 
1 for styloid process. 
1 for auditory process. 



2 for greater wings and ex- 
ternal pterygoid plates. 

2 for lesser wings and ante- 
rior part of body. 

2 for internal pterygoid 
plates. 

2 for posterior part of body. 

2 for sphenoidal turbinated 
— bones. 
10 

1 for lateral masses. 

2 for vertical lamella. 



1 for the whole bone. 



10 weeks. 

6 weeks, 
early. 
6 weeks. 



2 months. 

3 months. 

4 months. 

4 months. 
3 years. 



5 months 
1 year. 



6 weeks. 



43 



Superior 
Maxilla. 



Lachrymal. 
Malar. 

Palate. 



Inferior Tur- 
binated. 

Vomer. 



Inferior 
Maxilla. 



Hyoid. 



Sternum. 



CENTRES OF OSSIFICATION. 

skull. — Continued. 

1 for nasal andfacial portions. 

1 for orbital and malar por- 
tions. 

1 for incisive portion. 

1 for palate portion. 



1 for whole bone. 

1 for whole bone. 

1 for whole bone, which ap- 
pears at angle of junc- 
tion of two portions. 

1 for whole bone. 



2 for parallel lamellae of 
which it consists. 

2 for lateral halves. 

probably additional cen- 
tres for coronoid pro- 
cesses, condyles, angles 
and inner side of alveo- 
lar process. 

HYOID. 

1 for body. 

2 for greater horns. 
2 for lesser horns. 



THORAX. 

1 for manubrium. 

4 for gladiolus. 

1 for ensiform appendix. 



TIME OF APPEARANCE 



early. 



6 weeks. 
6 weeks. 



4 months. 



6 weeks. 



very early. 



8 months. 
8 months. 
6 months after 
birth. 



6 months. 
6 mos. to 1 yr. 
2 to 18 years. 



44 



COMPEXD OF ANATOMY. 



Eib. 



Clavicle. 



Scapula. 



Humerus. 



Ulna. 



Radius. 



CENTRES OF OSSIFICATION. 


TIME OF APPEARANCE. 


thorax. — Continued. 
1 for shaft. 
1 for head. 
1 for tubercle. 


3 weeks. 
18 years. 
18 years. 


~Z last two ribs have no 
tubercle and no centre 
there. 




UPPER EXTREMITY. 




1 for shaft. 

1 for sternal extremity. 

2 

1 for body. 


very early; first 

in skeleton. 
20 years. 


2 months. 


2 for coracoid process. 
2 for acromion. 
1 for posterior border. 
1 for inferior angle. 

7 

1 for shaft. 

1 for head. 

1 for greater tuberosity. 

1 for radial head. 

1 for internal condyle. 

1 for trochlear surface. 

1 for external condyle. 

7 

1 for shaft. 

1 for inferior extremity. 

1 for olecranon. 

Q 


1 year. 
16 years. 
16 years. 
16 years. 


very early. 

2 years. 

3 years. 
2 years. 
5 years. 
12 years. 
14 years. 


5 weeks. 
4 years. 
10 years. 


O 

1 for shaft. 

1 for lower extremity. 

1 for head. 


very early. 
2 years. 
5 years. 



45 



Carpus. 



Metacarpals, 
(2d, 3d, 4th, 
and 5th). 



Metacarpal 
of thumb. 



Phalanges. 



Innominate 
bone. 



CENTRES OF OSSIFICATION. 



jpper extremity — Continued 




1 for os magnum. 
1 for unciform. 


1 year. 
1 year. 


1 for c ] neiform. 


3 years. 


1 for semilunar. 


5 years. 


1 for trapezium. 
1 for scaphoid. 
1 for trapezoid. 
1 for pisiform. 

8 

1 for shaft. 


5 years. 

6 years. 
8 years. 
12 years. 


6 weeks. 


1 for head. 

2 

1 for shaft. 


3 years. 


6 weeks. 


1 for base. 

2 

1 for shaft. 


3 years. 


6 weeks. 


1 for base. 


4 to 5 years 



LOWER EXTREMITY. 

3 primary, 

1 for ilium. 
1 for ischium. 
1 for pubes. 
5 secondary, 

1 for Y- shaped piece in 

acetabulum. 
1 for crest of ilium. 
1 for anterior inferior 

spinous process. 
1 for tuberosity of isch- 
ium. 
1 for symphysis of pubes. 



TIME OF APPEARANCE. 



8 weeks. 
3 months. 
5 months. 

14 years. 

20 years. 
20 years. 

20 years. 

20 years. 



46 



COMPEND OF AX ATOMY. 



BONE. 

Femur. 



Patella. 


1 for whole bone. 


Tibia. 


1 for shaft. 
1 for head. 
1 for lower extremity. 


Fibula. 


3 

1 for shaft. 

1 for lower extremity 

1 for head. 



Tarsus. 



Metatarsals. 

(2d, 3d, 4th 

and 5th.) 

Metatarsal 
of great toe. 



Phalanges. 



CENTRES OF OSSIFICATION. 

1 for shaft. 

1 for condyles. 

1 for head. 

1 for greater trochanter. 

1 for lesser trochanter. 



1 for calcaneum. 

1 for astragalus. 

1 for cuboid. 

1 for external cuneiform. 

1 for internal cuneiform. 

1 for middle cuneiform. 

1 for scaphoid. 

1 for posterior extremity of 

— calcaneum. 

8 

1 for shaft. 
1 for head. 



1 for shaft. 
1 for base. 



1 for shaft. 
1 for base. 



TIME OF APPEARANCE. 



5 weeks. 
9 months. 
1 year. 
4 years. 
14 years. 



3 years. 

5 weeks. 

9 months. 
2 years." 

6 weeks. 

2 years. 

4 years. 

6 months. 

7 months. 

9 months. 
1 year. 

3 years. 

4 years. 
4 years. 

10 years. 

7 weeks. 
3 years. 



7 weeks. 
5 years. 



2 months. 
4 to 6 years. 



ARTICULATIONS AND LIGAMENTS. 47 



CHAPTER II. 



THE ARTICULATIONS AXD LIGAMENTS. 

A joint or articulation is a union of two or more bones of 
the skeleton, and may be immovable, movable, or partly 
movable. The immovable articulations, of which those of 
the cranium may be taken, as examples, have the bones in 
close contact, with only a thin layer of cartilage, or fibrous 
tissue between them. The partly movable joints, such as 
the inter-vertebral and inter-pubic, are formed by having 
the bones united by tough and elastic fibro- cartilages ; but 
the movable joints are much more elaborate in construction. 
The bones are covered by cartilage, and held together by 
non-elastic ligaments, forming a sort of capsule, which is 
lined by the synovial membrane, similar to a serous mem- 
brane in structure, secreting the synovial fluid to lubric.tte 
the structures forming the articulation. 

In situations where tendons, or the integument, glide over 
bony prominences there are developed sacs, similar to the 
synovial membrane in structure. These are called burses, 
or bursas, and are to limit friction. 

Many terms have been used to describe the different varie- 
ties of articulations, but a large number of them are useless 
to the student, and may be discarded. The most important 
are worthy of insertion and description. 

Gliding (arthrodia): as sterno- clavicular. 
Ball and Socket (enarthroais) ; as shoulder, 

hip. 
Hinge (ginglymus) ; as elbow, ankle. 
Rotatory (lateral ginglymusj: asatlo-axoid, 
head of radius. 

LIGAMENTS OF THE TRUNK AND HEAD. 

Spixal Column. — Inter-vertebral substances between the 
bodies of true vertebrae ; anterior common ligament along 
front of bodies from axis to sacrum ; posterior common along 
back of bodies from axis to sacrum. Yellow elastic ligaments 
between the laminae of the movable vertebrae ; capsular sur- 
rounding the articular processes. Inter-spinous and supra- 



Movable Joints. 
(Diarthroses.) 



48 COMPEXD OF ANATOMY. 

spinous lying between and over the spinous processes re- 
spectively, and inter-transverse between the transverse pro- 
cesses. 

Atlas and Axis. — Anterior atlo-axoid from anterior arch 
of atlas to body of axis, and really a prolongation of anterior 
common of &pme ; posterior atlo-axoid from posterior arch 
of atlas to laminae of axis. Transverse, to keep odontoid 
process in position, stretches across from tubercles on inner 
surface of articular processes of atlas. Capsular are iden- 
tical with same ligaments in other regions of the spine. 

Occipital axd Atlas. — Anterior occipito atloid from 
basilar process to anterior arch, a sort of continuation of 
anterior common of spine; posterior occipito- atloid from 
posterior margin of great foramen to posterior arch ; lateral 
occipito- atloid from jugular process to transverse process of 
atlas. Capsular as in other regions of * pine. 

Occipital axd Axis. — Occipito- axoid from anterior mar- 
gin of great foramen to back of body of axis. It is really a 
mere prolongation of the posterior common ligament of 
spine. The odontoid or check are three in number,, though 
sometimes only the two lateral are described as check liga- 
ments, and the middle called the suspensory of the odontoid 
process. The three stretch from the top of the odontoid 
process to the sides and front of the great foramen. 

Lower Jaw. — External lateral from tubercle of zygoma 
to outside of neck of condyle ; internal lateral from spinous 
process cf sphenoid to inner border of dental foramen ; cap- 
sular from edge of glenoid cavity to neck of condyle. There 
is also an inter-articular fibro- cartilage w T ith a synovial mem- 
brane above, and another below it. Stylo maxillary from 
styloid process of temporal to angle of jaw. 

The stylo hyoid ligament has nothing to do with the jaw, 
but is in this region, connecting the styloid process and 
small horn of the hyoid bone. 

Ribs and Vertebrae. — The head of the rib and bodies 
of the vertebrae are connected by anterior costo-vertebral 
(stellate), consisting of three separate bands going to the 
body above, the body below, and the inter- vertebral disk 
between these; by the inter- articular ligament, which di- 
vides the joint, giving occasion for two synovial sacs, and 
extends from ridge on head to inter- vertebral cartilage ; and 
finally by a capsular. 

The rib is attached to the transverse processes by four 
ligaments ; anterior costo-transverse from upper edge of neck 



ARTICULATIONS AND LIGAMENTS. 49 

of rib to transverse process of vertebra above ; middle costo- 
transverse (interosseous) from posterior surface of neck to 
transverse process ; posterior costotransverse from tubercle 
to apex of transverse process ; and capsular. There are 
some modifications of these various ligaments depending on 
the peculiarities of certain ribs and vertebrae ; for example, 
if the rib articulates with but one body there can be no 
inter-articular ligament, and if the rib has no tubercle there 
will be no capsular ligament. 

Costal Cartilages and Sternum^ — Anterior costo-sternal 
from cartilage to front of sternum ; posterior costo-sternal 
from back of cartilage to back of sternum ; capsular, sur- 
rounding joint and enclosing synovial membrane. There is 
no synovial membrane at first joint, but there are two at the 
second, because there exists here an inter-articular ligament 
joining the costal cartilage with the cartilage between manu- 
brium and gladiolus. 

The joints between^tbe cartilages of the lower ribs are 
stregthened by capsular, and external and internal intercos- 
tal (interchondral) ligaments. The ribs are joined to the 
corresponding cartilages by the cartilages fitting into a de- 
pression in the end of the ribs and being held by the perios- 
teum. 

Sternum. — The first and second pieces of the sternum are 
united by anterior sternal and posterior sternal ligaments, 
and an intervening layer of cartilage. 

Pelvis and Spine. — The last lumbar vertebra and the 
sacrum are connected by the ligaments found in other 
regions of the spine, viz., anterior and posterior common, 
inter-vertebral substance, yellow elastic ligaments, inter- 
spinous, supraspinous and capsular-, and also by the lumbo- 
sacral from transverse process of fifth lumbar to lateral mas-s 
of sacrum. The lumbo-iliac extends from tip of same pro- 
cess to crest of ilium. 

Pelvis. — The sacrum and ilium are united by articular 
cartilages, with atjtimes a synovial sac, and anterior sacro- 
iliac and posterior sacro-iliac running across tke joint in 
front and behind. The sacrum is connected with the ischium 
by great sacro- sciatic (or posterior) stretched from the pos- 
terior inferior spine of ilium, and side of sacrum and coccyx 
to the tuberosity of ischium, thus completing the small 
sacro- sciatic notch ; and by the small sacro- sciatic (or 
anterior) from side of sacrum and coccyx to spine of 
ischium, completing the great sacro-sciatic notch. The sac- 



50 COMPEXD OF ANATOMY. 

rum and coccyx are joined by an intervening fibro-cartilage, 
and anterior and posterior sacro- coccygeal. The symphysis 
of the pubes consists of two articular cartilages with a syn- 
ovial membrane, and the two pubic bones, held together by 
anterior and posteri or pubic ligaments, a superior pubic and 
a subpubic. The first three are horizontal bands of fibres, 
while the fibres of the sub-pubic have an arched direction, 
running from one ramus to the other. The obturator liga- 
ment or membrane closes the obturator foramen except at 
its upper and outer part. 

UPPER EXTREMITY. 

Sternal End of Clavicle. — The joint between the ster- 
num and clavicle has an inter- articular fibro- cartilage, with 
two synovial membranes, and is united by the' following liga- 
ments : anterior sterno- clavicular, posterior sterno clavicu- 
lar, and inter clavicular passing across the top of the ster- 
num from one clavicle to the other. The clavicle is also 
attached to the thorax by the costo- clavicular ligament, often 
called the rhomboid, which passes from the first costal car- 
tilage to the lower surface of the clavicle. 

Acromial End of Clavicle. — There is sometimes an inter- 
articular fibro-cartilage found between the acromion and 
clavicle, but it is often absent. The joint is held by a su- 
perior and an inferior acromioclavicular ligament. This 
end of the clavicle is fastened to the coracoid process by the 
cor aco- clavicular ligament, consisting of two portions often 
designated conoid and trapezoid. 

Scapula. — The cor aco- acromial extends from the side of 
coracoid process to the tip of acromion, the transverse across 
the supra- scapular notch. 

Shoulder. — Capsular from edge of glenoid cavity to ana- 
tomical neck of humerus ; coraco-Jiumeral from coracoid to 
margins of bicipital groove ; and glenoid, which is a fibro- 
cartilaginous band deepening the glenoid cavity. The long 
tendon of Biceps also acts as a ligament. 

Elbow t . — Anterior from humerus, above coronoid fossa, to 
coronoid process of ulna and orbicular ligament ; posterior 
from border of olecranon fossa to olecranon process of ulna; 
internal lateral from inner condyle of humerus to edge of 
coronoid and olecranon processes ; external lateral from ex- 
ternal condyle to orbicular ligament. 

Radius and Ulna. — The orbicular ligament surrounds the 
head of the radius, having its ends attached to the borders of 



ARTICULATIONS AND LIGAMENTS. 51 

the lesser sigmoid cavity. The oblique extends fr.m tubercle 
at base of coronoid process to the radius just below the tu- 
bercle at which the biceps is inserted. The interosseous 
membrane is attached to the interosseous ridges of the bones. 
At the lower part of the forearm there is an anterior radio- 
ulnar, and a posterior radio-ulnar extending across the ar- 
ticulation in front and behind, and a triangular fibro- carti- 
lage beneath the inferior end of the ulna, attached to the 
styloid process of ulna and the edge of radius. 

Wrist. — Anterior from lower ends of radius and ulna in 
front to first row of carpal bones ; posterior from lower end 
of radius behind to first row of carpals ; external lateral from 
styloid process of radius to scaphoid ; internal lateral from 
styloid process of ulna to pisiform and cuneiform. 

Carpus. — There are palmar, dorsal and interosseous liga- 
ments, holding first row of carpal bones together, and palmar, 
dorsal and interosseous, holding the second row in position. 
There are in addition palmar, dorsal and lateral forming the 
attachment between the two rows. The external lateral 
passes from scaphoid to trapezium, the internal lateral from 
cuneiform to unciform. 

The synovial membranes in this vicinity are important. 
There are five in connection with the bones of the forearm, 
wrist, and metacarpus. 1, Above the triangular cartilage 
between radius and ulna ; 2, between the forearm above and 
first row of carpals below ; 3, a large sac lying between the 
first and second row of carpals, and extending down to line 
the joints between the carpus and metacarpus ; 4, a special 
membrane between the pisiform and cuneiform ; ' 5 a special 
one between the trapezium and metacarpal of thumb. 

Carpus and Metacarpus. — The articulation here is ac- 
complished by palmar, dorsal and interosseous ligaments, 
except in the case of the thumb, where there is only a strong 
capsular ligament. 

Metacarpus. — The bases are united by palmar, dorsal and 
interosseous, the heads by the transverse ligament running 
across the palmar surface. 

Metacarpus and Phalanges. — These joints are main- 
tained by & palmar and two lateral ligaments. The exten- 
sor tendons serve as dorsal ligaments. 

Phalanges. — The various phalanges are held together by 
palmar and lateral ligaments. The extensor tendons act as 
dorsal ligaments for the metacarpo-phalangal, and phalangal 
articulations. 



52 COMPEND OF ANATOMY. 

LOWER EXTREMITY. 

Hip. — The ligaments are very strong, as is required by the 
great range of motion allowed this joint. The capsular is 
attached to margin of acetabulum above, and to neck of 
the femur below ; in front, it is inserted into the inter-tro- 
chanteric line of femur, but behind, its attachment is to the 
middle of neck above inter-trochanteric line. The ilio- 
femoral extends from anterior inferior spine of ilium to 
anterior inter-trochanteric line, bifurcating and running 
towards the two trochanters. The round ligament (teres) 
attaches the depression in head of femur to the fossa at 
bottom of acetabulum. The cotyloid ligament is circular, 
fib ro- cartilaginous, and is attached to the edge of the aceta- 
bulum, just as the glenoid is in the shoulder joint. The 
transverse ligament crosses the cotyloid notch at the lower 
part of the acetabulum. 

Kxee. — The ligaments of this articulation are divided into 
the external and internal. The external are as follows : — ■ 
1, Anterior (ligament of patella), from apex of patelia to 
tubercle of tibia ; 2, posterior, from condyles of femur to 
head of tibia, being reinforced by an oblique fasciculus from 
tendon of Semi- membranous muscle ; 3, internal lateral, 
from inner condyle to inner side of head of tibia ; 4, long 
external lateral, from external condyle to head of fibula; 
5, short external lateral, from outer condyle to styloid pro- 
cess of fibula; 6, capsular, filling up intervals between these 
ligaments to complete the encasement of the articulating 
extremities of the bones. 

The internal - are as follows: anterior crucial, from fossa 
in front of spine of tibia to inner surface of external 
condyle : posterior crucial, from depression behind spine to 
inner condyle; internal semi-lunar fibro- cartilage, attached 
to tibia in front of the anterior crucial, and in front of the 
posterior crucial ligament ; external semi-lunar fibro- carti- 
lage, to tibia in front and behind spine, and is nearly cir- 
cular. It will, therefore, be seen that the ends of the 
semi lunar cartilages, except the anterior extremity of the 
internal cartilage, are all attached to the tibia between the 
crucial ligaments. The transverse ligament passes between 
the anterior extremities of the semi-lunar cartilages, while 
coronary ligaments on each side hold the semi-lunar car- 
tilages to the head of the tibia. The mucous and alar 
ligaments are really not ligaments, but folds of synovial 
membrane containing, perhaps, a little ligamentous tissue. 



ARTICULATIONS AXD LIGAMENTS. 53 

The former is attached to the lower part of the patella 
and to the inter-condyloid notch, while the latter are two 
fringe-like folds extending from the sides of the former. 

Tibia axd Fibula. — These bones are united above by an 
anterior sujjerior and a posterior superior tibiofibular 
ligament passing across the joint from external tuberosity 
of tibia to head of fibula. One lies in front and the other 
behind the joint. The shafts of the bones are united by the 
rosseous membrane fastened to the interosseous ridges. 
The lower extremities are joined by an intcj^osseons liga- 
ment, lying between the tibia and fibula ; by an anterior 
rior tibio-fibular and a posterior inferior tibio-fibular 
crossing the front and back of the articulation ; and by the 
transverse, which crosses the back of the joint from external 
malleolus nearly as far as internal malleolus. 

Axkle. — The ligaments of this hinge-joint are : anterior, 
from edge of articular surface of tibia to astragalus ; internal 
lateral (deltoid), from inner milleoius to astragalus, os calcis 
and scaphoid; external lateral, consisting of three bands 
running from outer malleolus to astragalus and os calcis. 
The anterior and posterior bards go to the astragalus, the 
middle to the os calcis. There is no posterior ligament, 
because transverse of tiba and fibula is sufficient. 

Tarsus — Flrst row of tarsal boxes. — Os calcis and 
astragalus by external calcaneo astragaloid, joining outer 
surfaces; posterior calcaneo- astragaloid, connecting pos- 
terior portions ; and interosseous, lying between the bones. 

Secoxd row of tarsal boxes. — Scaphoid, cuboid and 
cuneiform by dorsal, plantar and interosseous ligaments. 

Two rows of tarsal boxes with each other. — Os calcis 
and cuboid. Superior calcaneo cuboid on dorsal aspect ; 
interosseous, sometimes called internal calcaneo-cuboid, 
between the two bones ; long plantar (long calcaneo- 
cuboid), from in front of tuberosities of os calcis to ridge 
on plantar surface of cuboid ; short plantar (short calcaneo- 
cuboid), lying deeper, from lower surface of os calcis to 
lower surface of cuboid. 

Os calcis and scaphoid. Superior ccdcaneo-scaplioid from 
os calcis to outer side of scaphoid ; inferior ccdcaneo-sca- 
pJioid from sustentaculum process of os calcis to scaphoid. 

Astragalus and scaphoid. Superior astragalo-scaphoid 
from neck of astragalus to upper surface of scaphoid bone. 

Of all these ligaments there are two which it is especially 
important to recollect, because they, to a great extent, pre- 



54 C0MPEND OF ANATOMY. 

serve the arch of the foot. They are the long plantar (long 
calcaneo-cuboid) and the short plantar (short calcaneo- 
cuboid). 

Synovial membranes. — There are six synovial membranes 
concerned in the articulations of the tarsus and metatarsus. 
1. Between os calcis and astragalus, behind the interosseous 
ligament. 2. Between these bones in front of interosseous 
ligament and running up between astragalus and scaphoid. . 
3. Between os calcis and cuboid. 4. Between scaphoid and 
cuboid, and extending between scaphoid and three cunei- 
form bones, also between the cuneiform bones to the joints 
of se:ond and third metatarsals with middle and external 
cuneiform. 5. Between cuboid and fourth and fifth meta- 
tarsals. 6. Between internal cuneiform and first metatarsal. 

Tarsus axd Metatarsus. — Dorsal, plantar and inter- 
osseous ligaments. 

Metatarsus. — Dorsal, plantar and interosseous at bases ; 
a transverse metatarsal at heads. 

Metatarsus axd Phalanges. — Plantar and two lateral. 

Phalanges. — Plantar and two lateral. In each case the 
extensor tendons act as dorsal ligaments. 



MUSCLES, 55 



CHAPTER III. 



THE MUSCLES. 

There are two kinds of muscular tissue : voluntary, or 
striped (striated), and involuntary, or unstriped(non-striated). 
The former is frequently called that of animal life, because 
it is found to constitute the muscles concerned in locomotion 
and other functions specially pertaining to animals, and is 
under the influence of their will. The latter is called mus- 
cular tissue of organic life, because found in the coats of the 
involuntary organs. The first variety of muscular fibre is 
found in the muscles of the limbs, the external muscles of 
the head and trunk, those of the larynx and tongue ; and also 
in the heart, though this is an organ acting inde23endently 
of the will. Involuntary, or unstriped, muscle is met w th 
in the w # alls of the hollow viscera, as the lower part of oeso- 
phagus, intestinal tract, trachea, blood-vessels, ureters, and 
uterus ; and in the sexual organs, iris, and skin. The 
fibres of involuntary muscle form, as a rule, flat sheets, and 
usually have a peculiar motion, The characteristic of this 
motion is that one part of the muscular surface slowly con- 
tracts, and then slowly relaxes, while an adjacent part con- 
tracts. This is easily seen in the peristaltic, or vermicular, 
motion of the intestines. Under the microscope, involun- 
tary muscle is found to be composed of elongated cells, or 
bands, in which a rod-shaped nucleus is shown, especially 
if these cells, or fibres, are treated with acetic acid. 

The muscles of animal life, or the striped muscles, con- 
sist of bundles surrounded by cellular tissue. These bun- 
dles can be split up into smaller bundles, surrounded by cel- 
lular tissue, until at last the primitive, or smallest, bundles 
are reached. In the primitive bundles are seen the primi- 
tive fibres, or fibrillar. The cellular tissue surrounding the 
larger bundles (larger fasciculi) is called the perimysium; 
that surrounding the smallest bundles is also perimysium, 
but is sometimes termed the internal perimysium. The 
smallest bundles are composed of small fibres, or fibrillar, 
each one surrounded by the sarcolemma. If a primitive 
bundle of voluntary muscle is examined by the microscope, 



56 - . . COMPEND OF ANATOMY. 

fine dark lines, or striae, are seen running transversely. 
Hence this variety is called striped, or striated, muscle. 
Longitudinal lines -are also seen, indicating the fibrils of 
which the bundle consists. This would seem to show that 
the fibrils are made up of little cells placed in rows, 'like a 
number of beads on a string. 

By the origin of a muscle is meant the attachment of its 
fixed end, by the insertion, that of its more movable ex- 
tremity ; in other words, the origin is that attachment 
towards which motion takes place. In nearly all cases 
muscles may act from either extremity, as for example the 
muscles of the trunk and thighs, which may bend the lower 
extremities up towards the abdomen, or, if the limbs are 
held fixed, may flex the trunk over them, as in bowing. 
Hence the end usually fixed, or that nearer the trunk, is 
generally called the origin. A muscle is, as a rule, attached 
to the bone by a tendon, which is a cord of fibrous tissue, 
or by an aponeurosis, which is nothing less than a flattened 
tendon. 

A fascia is a layer of fibrous or fibro- cellular tissue sur- 
rounding organs and other structures. The superficial fascia 
consists of a fibrous network, in the cells of which adipose 
tissue is deposited. The deep fascia is a dense fibrous mem- 
brane investing the muscles and other structures, and thus 
forming sheaths, or coverings, separating various regions 
and parts. 



MUSCLES. 57 






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VASCULAR SYSTEM. 



CHAPTER IV. 



THE VASCULAR SYSTEM. 

The vascular system consists of the heart, arteries, capil- 
laries and veins ; to which may be added the lymphatic ves- 
sels and glands. The circulation of the blood may be divided 
into two circles, the pulmonary and the systemic ; which will 
be better understood if the direction of the blood current be 
described. The heart is a pump, forcing the venous blood 
through the lungs to become supplied with oxygen* and the 
arterial blood to the extremities and organs of the body to 
carry on the various nutritive processes there required. The 
heart itself will be described with the thoracic viscera ; but 
it is necessary, at this point, to state that the right side of 
the heart receives the impure blood, or that coming from the 
veins and containing carbonic acid, and sends it through the 
pulmonary artery to the lungs. Here it absorbs oxygen and 
returns by the pulmonary veins to the left side of the heart, 
whence it is driven, through the aorta and its branches, to 
the tissues of every region. The smallest arteries open into 
small tubes called capillaries, which in turn empty into the 
smallest veins ; these gradually unite with other veins and 
finally pour the blood, which is now full of carbonic acid and 
wanting in oxygen, into the venae cavae. These largest veins 
open into the right side of the heart, after which the round 
of the pulmonary and then that of the systemic circulation 
is gone over again. 

Arteries consist of three coats, an internal or serous, a 
middle or muscular and elastic, and an external or con- 
nective tissue coat. They are usually enclosed in a sort of 
loose bag called the sheath, which in many cases also sur- 
rounds the vein accompanying the artery. Arteries have 
small nerves and very small arteries running in their wa Is, 
to supply proper nerve force and blood to the cells of which 
they are composed. The capillaries have, as a rule, but 
one very thin transparent coat ; while the veins have three, 
like the arteries, though the middle coat is much weaker 
than that of the arteries. The veins are supplied in many 



90 COMPEND OF ANATOMY. 

regions with valves, which are formed of a folding inwards 
of the inner and part of the middle coat. The following 
veins have no valves, because the current of blood seems not 
to require them : venae cavae, hepatic, portal, renal, uterine 
and ovarian, cerebral, spinal, and pulmonary. 

THE ARTERIES. 

AORTA. 

The aorta is the main trunk from which the arteries of 
the systemic circulation receive their blood. It commences 
at the top of the left ventricle, makes a curve across to the 
left side of the vertebral column, passes down between the 
peduncles of the diaphragm, and, opposite the body of the 
fourth lumbar vertebra, divides into the two common iliac 
arteries. It is divided, for description, into three parts : the 
arch, extending from the heart to the lower border of the 
body of the fourth dorsal vertebra; the thoracic aorta, from 
the lower border of the fourth dorsal to the body of the last 
dorsal, where the opening in the diaphragm is situated ; and 
the abdominal aorta, extending from the diaphragm to the 
body of the fourth lumbar Vertebra. The arch is divided 
into the ascending, transverse and descending parts. The 
ascending extends from a point, corresponding with the 
middle of the sternum, on a level with the third costal 
cartilage, to the upper border of the second right costal 
cartilage ; the transverse from the latter point to the left 
side of third dorsal vertebra, whence the descending portion 
is continued to the lower border of fourth vertebra. The 
arch curves over the root of the left lung ; the thoracic aorta 
lies behind the left pleura, and the abdominal behind the 
peritoneum. 

The branches of the aorta are as follows: — 
From the Arch. 

1. Two coronary, 3. Left common carotid, 

2. An innominate, 4. Left subclavian. 

From the Thoracic. 

5. Pericardial, 8. Posterior mediastinals, 

6. Bronchials, 9. Twenty intercostals. 

7. (Esophageals. 



ARTERIES. 91 

From the Abdominal. 

10. Two phrenic, 15. Two spermatic, 

11. A cceliac axis, 16. An inferior mesenteric, 

12. A superior mesenteric, 17. Eight lumbar, 

13. Two suprarenal, 18. A middle sacral, 

14. Two renal, 19. And terminates in two 

common iliacs. 
Coronary. — The coronary arteries are given off at the 
beginning of the arch of the aorta, behind the semi-lunar 
valves, and run in the grooves between the right and left 
sides of the heart. The left artery occupies the anterior 
groove. 

ARTERIES OF THE HEAD AND NECK. 

Ixxomixate. — This trunk arises from the summit of the 
aortic arch, and proceeds to the right sterno- clavicular junc- 
tion, where it divides into the right common carotid and 
right subclavian. The left common carotid and the left sub- 
clavian arise directly from the arch of the aorta. 

Common Carotid. — Though the arteries of the two sides 
of the neck have a different origin, their branches and dis- 
tribution are similar, since the left carotid soon reaches the 
left sterno-clavicular junction, and is then identical with the 
right. A line, drawn from the sterno-clavicular articulation 
to a point midway between the mastoid process and angle of 
the lower jaw, indicates the course of the vessel, which bi- 
furcates, however, into the external and internal carotids at 
the level of the top of the thyroid cartilage. The artery is 
crossed about the middle of its course by the Omo-hyoid 
muscle, and lies under the inner border of the Sterno- 
mastoid muscle. In the sheath of the artery are enclosed 
the internal jugular vein, on the outer side, and the pneu- 
mogastric nerve. On the front surface of the sheath lies the 
descending branch of the hypoglossal nerve. The common 
carotid has no branches except the terminal ones already 
mentioned, of which the internal carotid is the one further 
from the median line. 

External Carotid. — This artery is so called because it 
supplies the external portion of the head, and not because 
of its location in regard to the other artery, which, though 
external in situation, is called the internal carotid, on ac- 
count of its supplying the interior of the cranium. The ex- 
ternal carotid extends from the bifurcation of the common 



92 COMPEND OF ANATOMY. 

carotid, at the top of the larynx, to the neck of the condyle 
of the lower jaw ; here it terminates by dividing into the 
temporal and internal maxillary. Its course is a continua- 
tion of the line of the common carotid artery. 

The branches of the external carotid and the important 
sub-branches are as follows : — 

1. Superior Thyroid, given off below hyoid bone, runs to 

thyroid gland : — 
muscular, superior laryngeal, 

hyoid, crico-thyroid. 

sterno-mastoid, 

2. Lingual, runs under Hyoglossus muscle :— 

hyoid, sublingual, 

dorsal of tongue, ranine. 

3. Facial, crosses lower jaw in front of Masseter : — 

Cervical branches. Facial branches. 

ascending pa- muscular, 

latine, ' inferior labial, 

tonsillar, inferior coronary, 

submaxillary, superior coronary, 

submental. lateral nasal, 
angular. 

4. Occipital, passes beneath Digastric and lies in groove 

under mastoid process : — 
muscular, principal of neck (prin- 

auricular, ceps cervicis), 

inferior meningeal, cranial. 

5. Posterior auricular, ascends through parotid gland be- 

hind auricle : — 
stylo-mastoid, auricular. 

6. Ascending pharyngeal, lies on Greater anterior rectus of 

head and ascends to base of the skull : — 
external, meningeal, 

pharyngeal, 

7. Temporal, is one of the terminal branches of the external 

carotid, and, traversing the parotid gland, 
crosses the zygomatic arch and divides into 
anterior and posterior temporal : — 
transverse facial, anterior tomporal, 

middle temporal, posterior temporal, 

anterior auricular, 

8. Internal maxillary, the larger terminal branch, is divis- 

ible into three portions, according to its loca- 
tion in different parts of its course. 



ARTERIES. 93 

The Maxillary portion runs directly forwards 
between the ramus of the jaw and the inter- 
nal lateral ligament : — 
tympanic, middle meningeal, 

small meningeal, inferior dental, dividing 

into incisor and men- 
tal. 
The Pterygoid portion runs upwards and for- 
wards upon the External pterygoid mus- 
cle : — 
deep temporal, pterygoid, 

masseteric, buccal. 

The Spheno-maxillary portion lies in the spheno- 
maxillary fossa and curves upwards, usually 
piercing the External pterygoid muscle : — 
alveolar, giving off superior dental, 
infraorbital, 

posterior or descending palatine, 
Vidian, 

pterygo - palatine , 
naso -palatine. 
The teeth, then, are supplied with blood as follows : — 
Those of the lower jaw receive blood from the first portion 
of the internal maxillary by the inferior dental branch, and 
by the incisor, its continuation. In the upper jaw, the 
molars and bicuspids are supplied by the superior dental 
branch of the alveolar, coming from the third portion of the 
internal maxillary, and the front teeth by small branches 
from the infraorbital, coming also from the internal max- 
illary. 

The Internal Carotid, starting at the point of bifurca- 
tion of the common carotid, opposite the top of the larynx, 
ascends and enters the cranium through the carotid canal, 
in the petrous portion of the temporal bone. In the first, 
or cervical, portion of its course, the artery runs almost 
vertically up the neck to the petrous portion of the tempo- 
ral bone. It is in relation with the internal jugular vein 
and pneumogastric nerve, lying at its outer side, and with 
the pharynx and tonsil on its inner side. The petrous por- 
tion lies in the temporal bone and makes abrupt curves 
during its passage through the canal , the cavernous portion 
lies at the inner side of the cavernous sinus, extending to 
the anterior clinoid process ; the cerebral portion is short, 



94 COMPEND OF ANATOMY. 

and curving upwards from this point pierces the dura 
mater. 

Branches of internal carotid — 
From cervical portion, none, 
" petrous " tympanic, 

" cavernous " anterior meningeal, 
op/it/ialmic. 

from which 
lachrymal, muscular, 

supra- orbital, anterior ciliary, 

anterior ethmoidal, short ciliary, 
posterior " long ciliary, 

palpebral, central of retina, 

frontal, 
nasal, 
" cerebral " posterior communicating, 
anterior cerebral, 

anterior communicating, 
middle cerebral, 
anterior choroid. 
The circle of Willis is a name given to the anastomosis 
of the branches of the two internal carotid and two verte- 
bral arteries at the base of the brain. The two vertebrals 
form a large trunk called the basilar, which gives off, besides 
other branches, two posterior cerebrals. The circle is then 
formed 

by two anterior cerebral, 
two middle cerebral, 
two posterior cerebral, 
two posterior communicating, 
one anterior communicating. 
These anastomose in the following manner : the two 
anterior cerebrals are joined together by the anterior com- 
municating, and the middle cerebral of each side is joined 
to the corresponding posterior cerebral by a posterior com- 
municating. 

ARTERIES OF THE UPPER EXTREMITY. 

The Subclavian is considered the first artery of the upper 
extremity, although some of its branches are distributed to 
the head and neck. The subclavian may be regarded as 
divided into three portions by the Anterior scalene muscle, 
viz., the part internal, that behind, and that external to the 
muscle. The first part has different relations on the two 



ARTERIES, 95 

sides, on account of the difference in origin. On the right 
side the artery is formed with the common carotid by the 
bifurcation of the innominate ; on the left side it is given 
off directly by the transverse portion of the arch of the aorta. 
Hence on the left side it is longer, and ascends almost ver- 
tically to the inner border of the Anterior scalene, while on 
the right side it arches upwards and outwards to that point. 
The subclavian extends to the outer border of the first rib, 
where it becomes the axillary. It projects a little above the 
clavicle, and is separated from the subclavian vein by the 
Anterior scalene muscle. 

Its branches are as follows, all given off from the first por- 
tion, except the last, which, on the right side, arises from the 
second portion. 

Vertebral, ascending through transverse processes of six 
cervical vertebrae, and entering skull by the great 
foramen : — 
lateral spinal, anterior spinal, 

muscular, posterior spinal, 

posterior meningeal, inferior cerebellar, 

basilar, 
(formed by union of both vertebrals, lies along middle 
of pons Varolii). The branches of the basilar are : — 
transverse, superior cerebellar, 

anterior cerebellar, . posterior cerebral. 

Thyroid axis, 
inferior thyroid, 

laryngeal, oesophageal, 
tracheal, ascending cervical, 
suprascapular, 
transverse of neck, 

superficial cervical, 
posterior scapular. 
Internal mammary, running on inside of costal cartilages, 
parallel to sternum : — • 
superior phrenic, 
pericardiac, 
anterior intercostal, 
perforating, 
musculo-phrenic, 
superior epigastric, 
Superior Intercostal, 

deep cervical. 



OG COMPEXD OF ANATOMY. 

Axillary. — This is the continuation of the subclavian, 
and extends from the outer border of the first rib to the 
lower margin of the tendons of the armpit muscles. The 
Lesser pectoral muscle divides it into three parts, that in- 
ternal, that behind, and that external to the muscle, 
superior thoracic, subscapular, 

acromial thoracic, dorsal of scapula, 

long thoracic, anterior circumflex, 

alar thoracic, posterior circumflex. 

Brachial. — The brachial is the continuation of the axil- 
lary, and runs at first along the inner border of the Coraco- 
brachial and Biceps, but finally gets to the front of the arm 
and terminates at a point about half an inch below the 
elbow, where it divides into radial and ulnar. Its branches 
are — 

superior profunda, great anastomotic, 

nutrient, muscular, 

inferior profunda, 
Radial from bifurcation of the brachial to deep palmar 
arch of hand. It runs between the Long supinator and the 
Radial extensor of the wrist, and has the radial nerve to its 
radial side. It curves around the base of the thumb on the 
outside, and then forms the deep palmar arch. 

radial recurrent, dorsal of thumb (two), 

muscular, dorsal of index finger, 

superficial volar, principal of thumb, 

anterior carpal, radial of the index, 

posterior carpal, perforating, 

metacarpal, interosseous. 

Ulnar. — From bifurcation of brachial to superficial palmar 
arch. At first it is deeply situated, but then runs between 
the Ulnar flexor of wrist and the Superficial flexor of fingers, 
with the ulnar nerve to its ulnar side. It forms the super- 
ficial palmar arch, anastomosing with the superficial volar, 
anterior ulnar recurrent, anterior carpal, 

posterior ulnar recurrent, posterior capal, 

interosseous, j ^^0^ dee P brancn > 

muscular, digital. 

Palmar Arches. — The superficial palmar arch is the termi- 
nation of the ulnar, and lies on a line with the anterior bor- 
der of the extended thumb ; while the deep arch, the termi- 
nation of the radial, is about a finger's breadth behind this. 
The arches are connected by the superficial volar and deep 



'Arteries. 97 

branch of ulnar. The fingers are each supplied by two 
arteries on the dorsal and two on the palmar surface, which 
come from the arches, or from the interosseous branches. 

ARTERIES OF THE TRUNK. 

The Thoracic Aorta extends from lower border of fourth 
dorsal vertebra to body of last dorsal. This portion of the 
aorta and its branches have been described sufficiently on a 
previous page (p. 90). 

Abdominal Aorta, from the body of last dorsal to body 
of fourth lumbar vertebra. Its branches have been given, 
but must be recapitulated, in order to show their distribu- 
tion : — 

Phrenic, or diaphragmatic. 

' gastric, to stomach, 
hepatic, to liver, etc., 
pyloric, 
Celiac axis, \ gastro- duodenal _ _ 

right gastro-epiploic, 
superior pancreatico- duodenal, 
cystic, 
splenic, to spleen, etc., 
, pancreatic, 

left gastro-epiploic, 
gastric branches (vasa brevia). 
Superior mesenteric, 

inferior pancreatico- duodenal, 
small intestinal branches, 
middle colic, 1 
right colic, Y to colon, 
ileo-colic, J 
Supra- renal* 
Renal, 

Spermatic, or ovarian. 
Inferior mesenteric, 

left colic, 
sigmoid, 

superior hemorrhoidal. 
Lumbar (four on each side). 
Middle Sacral. 

Common Iliac- -The common iliacs are formed by the 
bifurcation of the aorta at the left of the fourth lumbar 
vertebra, and hence about one inch below and a little to 

7 



98 COMPEXD OF ANATOMY. 

the left of the umbilicus. Each artery runs downwards and 
outwards, until at the level of the intervertebral substance, 
between the last lumbar vertebra and the sacrum, it divides 
into 

Internal iliac, to supply the pelvic organs, etc. 
External iliac, to supply most of lower extremity. 
Each common iliac is crossed, near its bifurcation into the 
terminal branches, by the ureter. 

Ixternal Iliac extends from lumbo- sacral articulation to 
great sacro-sciatic notch, where it divides into 
An anterior trunk, 
A posterior trunk. 
In the foetus the main portion of the anterior trunk is 
called the hypogastric, and passes up to the umbilicus, where 
it leaves the body and goes to the placenta. After birth the 
portion between the umbilicus and the top of the bladder 
becomes a fibrous cord (posterior f.^lse ligament of the blad- 
der), while the portion between the bladder and anterior 
trunk of the internal iliac becomes reduced in size and re- 
mains as the superior vesical artery. 

Anterior Trunk of Internal Iliac 
Superior vesical, 1 
Middle" vesical, > to bladder. 
Inferior vesical, J 
Middle hemorrhoidal to rectum. 

Obturator passing through obturator foramen to thigh. 
Internal pudic passing out by greater, and into pelvis 
again by lesser sacro-sciatic notch, 
inferior hemorrhoidal. 
t 1 superficial, 
P ermeal '| transverse. 

1 artery of the bulb, 
branches to genitals, h " of corpus cavernosum, 
J dorsal of penis. 
Sciatic. 

In the female the anterior trunk of internal iliac gives off 
uterine and vaginal : and the genital branches of the in- 
ternal pudic go to the corresponding parts of the vagina an: 1 
clitoris. 

Posterior Trunk of Internal Iliac, 
Ilio-lumbar, 

Lateral sacral, { ff^Z' 
1 {inferior, 



ARTERIES. 99 

Gluteal, 

superficial, 
deep, 

nutrient (to ilium). 
External Iliac. — From its origin, at the bifurcation of the 
common iliac, it passes along the margin of the Great psoas 
muscle, to make its exit from the pelvis under the middle of 
Poupart's ligament. It then becomes the common femoral 
artery. 

Deep epigastric. 
Deep circumflex iliac. 
The veins accompanying all the iliac arteries, except the 
right common iliac, lie to the posterior and inner sides of 
their respective arteries. The right common iliac vein, on 
the contrary, lies to the outer side of its artery. 

ARTERIES OF LOWER EXTREMITY. 

Common Femoral. — Extends from under middle of Pou- 
part's ligament to its bifurcation into superficial and deep 
femoral. This point is very variable, but is usually one and 
a half or two inches below Poupart's ligament. The com- 
mon, and the upper portion of the superficial femoral bisect 
Scarpa's triangle, which is formed by Poupart's ligament 
for its base, and the Sartorius and the Long adductor for its 
sides. 

Superficial epigastric. 
Superficial circumflex iliac. 

Externalpudic^JP^™ 1 

Superficial femoral, extends from bifurcation of common 
femoral to opening in Great adductor, when it becomes the 
popliteal. The line of common and superficial femorals is 
from middle of Poupart's ligament to inside of inner con- 
dyle. 

Muscular, 
Great anastomotic. 
Deep femoral (profunda femoris). This trunk arises at 
the bifurcation of the common femoral and supplies many of 
the thigh muscles. The common and superficial femoral are 
often described as the superficial femoral ; and the deep fe- 
moral is then considered a branch of the superficial vessel. 
External circumflex. 



Articular, 



100 COMPEND OF ANATOMY. 

Internal circumflex (passes through an opening between 

the Psoas and Pectineus). 
Three perforating. 

nutrient. 
Terminal branch (often called fourth perforating). 
Popliteal. — Extends from opening in Great adductor to 
lower edge of Popliteus muscle ; then divides into anterior 
and posterior tibial. 

Muscular, I ? u F? or > 

1 { interior or sural. 

f 1, external, 
superior, {^internal/ 

inferior I 3 > external > 
interior, ^ ^ internaL 

azygos. 

Anterior Tibial. — This artery extends from lower edge 
of Popliteus muscle to the middle of the ankle joint in front. 
It, in the upper part of its course, lies upon the front of the 
interosseous ligament, and then comes forward, lying at the 
outside of the Anterior tibial muscle. It finally becomes 
the dorsal artery of the foot. Recollect that tibial nerves 
lie to fibular side of tibial arteries. 

Recurrent tibial. 

Muscular. 

Malleolar, Ji«^ndL 

' { external. 
Dorsal of foot, from middle of ankle to first interosseous 
space. 
Tarsal. 
Metatarsal. 

Interosseous and digital. 
Dorsal of great toe (which is really an in- 
terosseous coming from main trunk). 
Communicating. 
Posterior Tibial. — From lower border of Popliteus mus- 
cle to inner side of calcaneum below the inner malleolus, 
where it divides into internal and external plantar. 

Peroneal (runs along inner border of fibula on posterior 
part of leg). 
Anterior peroneal. 
Muscular. 
Nutrient. 
Co mmunicating. 
Internal calcanean. 



VEINS. 101 

Internal plantar is smaller than external plantar, and runs 
along inner border of sole. 

External plantar. After getting to outer border of sole 
it curves towards the great toe, forming the plantar 
arch, which joins the communicating branches of the 
dorsal. There is, therefore, only one arch in the 
foot, and it lies across the bases of the metatarsal 
bones. In the hand there are two palmar arches. 
Plantar arch. 

Posterior perforating (anastomosing with interosseous 

of metatarsal). 
Digital (arranged very much like digital in palm). 
Anterior perforating. 

PULMONARY ARTERY. 

This artery, which carries the venous blood from the right 
heart to the lungs, has already been mentioned in describing 
the course of the circulation. It leaves the right ventricle 
at the top, and lies in front of the aorta. It is very large 
and about two inches long. It divides into the right and 
left pulmonary arteries, each of which goes to a lung and 
rapidly divides into small branches. 

THE VEINS. 

The veins carry blood towards the heart. There are two 
venous systems: the pulmonary veins, carrying arterial 
blood, from the capillaries in the lungs, to the left auricle, 
and the systemic veins, returning the venous blood from 
the various organs and limbs to the right auricle. The por- 
tal vein, with its capillaries, called the portal venous system, 
is an appendage of the systemic circulation, and is located 
in the abdomon. The capillaries in the digestive organs 
conduct the blood towards one large trunk which enters the 
liver. This trunk is the portal vein, and in the liver breaks 
up into capillaries, which empty their contents into other 
capillaries. These finally coalesce to form the hepatic veins, 
which empty into the vena cava. 

PULMONARY VEINS. 

These are formed from capillaries communicating with 
the minute divisions of the pulmonary arteries in the walls 
of the air vesicles of the lungs. They are usually two in 
number from each lung and empty into the left auricle. 



102 COMPEXD OF ANATOMY. 

They, of course, carry oxygenated or arterial blood. It 
must be remembered that the lungs have small arteries and 
veins, belonging to the systemic circulation, which nourish 
the tissues of the lungs. They are called bronchial arteries 
and veins, and accompany the ramifications of the bronchial 
tubes. 

SYSTEMIC VEINS. 

The systemic veins are divided into three classes, super- 
ficial, deep, and sinuses. 

The superficial lie between the layers of the superficial 
fascia, and are given names according to their locality, or 
from mere fancy of the early anatomists. 

The deep veins accompany the arteries, usually in the 
same sheath ; and as a rule are called after the arteries, 
thus the femoral vein follows the course of the femoral ar- 
tery. There are some exceptions, however, for the carotid 
artery has the internal jugular vein at its side. These deep 
veins are therefore called accompanying veins (venae comi- 
tes). The large arteries have only one accompanying vein 
(vena comes), while the smaller arteries have two — one on 
each side. 

Sinuses are venous channels within the skull, formed by a 
separation of the layers of the dura mata. They are unlike 
veins in their structure, but serve the same purpose. 

In describing the veins it will be well to group them into 
three classes : — 

1. Those of the head, upper extremity and thorax, ter- 

minating in the superior vena cava. 

2. Those of the abdomen, pelvis and lower extremity, 

emptying into the inferior vena cava. 

3. The cardiac veins, opening directly into the right au- 

ricle. 
It should be remembered that the veins communicate in 
all directions by small irregular branches, and that anom- 
alies are frequent. 

VEINS OF THE HEAD. 

The veins of the exterior of the head are — 

Facial, Temporo- maxillary, 

Temporal, Posterior auricular, 

Internal maxillary, Occipital. 

Facial. — The facial, commencing as the frontal vein, runs 
down the forehead to the root of the nose, where the veins 



VEINS. 103 

of the two sides are connected by the nasal arch ; thenco 
along the inner canthus as the angular ; beyond which point 
it is the facial vein. It crosses the lower jaw just in front 
of the Masseter muscle, and, after receiving the temporo- 
maxillary, empties into the internal jugular. 
It receives the following branches : — 
Supra- orbital, Buccal, 

Nasal, Masseteric, 

Superior palpebral, Submental, 

Inferior palpebral, Inferior palatine, 

Superior labial, Sub-maxillary, 

Inferior labial, Ranine. 

Temporal. — The temporal, commencing at the top of the 
head, runs down behind the condyle of th3 jjw and forms, 
by uniting with the internal maxillary, the temp or o- maxillary 
vein. 

It is joined by — 

Middle temporal, Anterior auricular, 

Parotid, „ Transverse facial. 

Internal Maxillary. — The internal maxillary starts in the 
pterygoid plexus, formed by the junction of the several 
branches mentioned below, and it then unites with the tem- 
poral behind the condyle of the jaw. The branches forming 
the pterygoid plexus correspond with those from the internal, 
maxillary artery, and are as follows : — 

Middle meningeal, Masseteric, 

Deep temporal, Buccal, 

Pterygoid, Palatine. 

Temporo maxillary. — The temporo-maxillary vein passes 
from the junction of the temporal and internal maxillary 
downwards into the parotid gland, where it divides into two 
branches, one joining the facial, the other, the external 
jugular. It receives only the posterior auricular. 

Posterior Auricular, — The posterior auricular, starting 
upon the side of the head, runs down behind the ear and 
joins the temporo-maxillary to form the external jugular. 
It receives — 

Stylo-mastoid; 
Branches from external ear. 
Occipital. — The occipital, commencing just behind the 
vertex of the head, passes downward with the occipital ar- 
tery to empty into the internal jugular. It communicates 
with lateral sinus by the mastoid. 



104 COMPEND OF ANATOMY. 

VEINS OF THE NECK. 

These are five in number — 

External jugular, 

Anterior jugular, 

Posterior jugular, 

Internal jugular, 

Vertebral. 
External Jugular. — The external jugular is formed by the 
union of the temporo-maxiliary with the posterior auricular 
in the parotid gland, and passes downwards through the neck 
to empty into the subclavian. Its direction is that of a line 
drawn from the angle of the jaw to the middle of the clavi- 
cle. The superficial cervical nerve crosses it ; and running 
with it at its upper part is the great auricular nerve. It has 
two valves, and receives — 

Posterior jugular, 

Supra- scapular, 

Transverse cervical. 
Posterior Jugular. — The posterior jugular draws the blood 
from the upper and back part of the neck, and terminates in 
the external jugular a little below the middle. 

Anterior Jugular. — The anterior jugular carries the blood 
from the superficial parts in the anterior portion of the 
neck, and empties into the external jugular. It has no 
valves. 

Internal Jugular. — The internal jugular, commencing at 
the posterior lacerated foramen, or jugular foramen, where 
the lateral and inferior petrosal sinuses unite, runs down the 
neck on the outer side of the internal and common carotid 
arteries, and joins the subclavian to form the innominate 
vein. It is accompanied by the pneumogastric nerve, and 
has only one pair of valves. 
Its branches are — 

Facial, 

Lingual, 

Pharyngeal, 

Superior thyroid, 

Middle thyroid, 

Occipital (previously described). 

Vertebral. — The vertebral vein collects blood from the 

occipital portion of the head, and runs down the side of the 

spinal column to open into the innominate. It does not 

enter the skull like the vertebral artery, but draws the blood 



VEINS. 105 

from the exterior of the head and neck, and the interior of 
the spinal canal. It passes through the foramina in the 
transverse processes of the upper six, and, sometimes, of all 
the cervical vertebrae, making a bend outwards, to enter that 
of the atlas. It has one pair of valves and is joined by the 
following: — 

Posterior condyloid, 

Muscular, 

Dorsi- spinal, 

Meningo-rachidian, from interior of spinal canal, 

Ascending cervical, 

Deep cervical. 

VEINS OF THE DIPLOE. 

Diploic Veins. — The diploe of the skull is traversed by a 
large number of veins running irregularly through it Four 
chief trunks have been distinguished : a frontal, running 
through the supra- orbital notch ; an anterior and posterior 
temporal, one terminating by joining the deep temporal and 
the other in the lateral sinus ; and an occipital, which emp- 
ties into the occipital vein or the occipital sinus. It is thus 
evident that there are two veins called occipital. 

VEINS OF THE BRAIN. 

Cerebral Veins. — The cerebral veins are devoid of muscu- 
lar tissue and valves. They are superficial and deep. 

The superficial run along the fissures between the convo- 
lutions and empty into the various sinuses. There are on 
each side eight superior, emptying into the superior longi- 
tudinal sinus ; and about eight inferior, called anterior, lateral 
and median inferior. The anterior empty into the cavernous 
sinus, the lateral into the lateral sinus, and the median into 
the straight sinus. 

The deep cerebral or ventricular veins, called veins of Ga- 
len, are formed by the veins of the corpora striata and the 
choroid veins, and, running backwards in the velum inter- 
positum, through the transverse fissure, empty into the 
straight sinus. One comes from each lateral ventricle. 

Cerebellar Veins. — The cerebellar veins occur in three sets, 
superior, inferior and lateral, and empty into the straight, 
lateral and superior petrosal sinuses, respectively. 

The Sinuses of the Dura Mater. — These are fifteen in 
number, seven upon the upper and back portions of the 



106 COMPEND OF ANATOMY. 

skull, and eight upon its base. Those of the former set 
are — 

Superior longitudinal, 

Inferior longitudinal, 

Straight, 

Lateral (2), 

Occipital (2). 
Superior Longitudinal. — The superior longitudinal, com- 
mencing in the foramen caecum, extends along the whole of 
"the upper border of the falx cerebri and empties into the tor- 
cular Herophili. At the torcular Herophili six sinuses meet, 
the superior longitudinal, the straight, the two lateral and 
the two occipital. 

Inferior Longitudinal. — The inferior longitudinal sinus 
is situated in the lower free border of the falx cerebri, and 
runs backwards to the straight sinus, in which it termin- 
ates. 

Straight. — The straight sinus is formed at the attach- 
ment of the falx cerebri to the tentorium cerebelli. It re- 
ceives the inferior longitudinal sinus and the two veins of 
Galen. 

Lateral. — The lateral sinuses are contained within the 
attached edges of the tentorium, and curve outwards, then 
forwards and inwards to the posterior lacerated foramen, 
where each opens into the internal jugular vein. They re- 
ceive the superior longitudinal, the straight, and two occi- 
pital sinuses. 

Occipital. — The occipital, the smallest sinuses, run from 
the foramen magnum, parallel with each other, backwards 
and upwards to the torcular Herophili. 

The sinuses upon the base of the skull are — 

Cavernous (2), 

Circular, 

Inferior petrosal (2), 

Transverse, 

Superior petrosal (2). 
Cavernous. — The cavernous sinuses lie on either side of 
the sella Turcica, and, commencing at the sphenoidal fissure, 
run backwards to the apex of the petrous portion of the tem- 
poral bone, where they are continuous with the inferior pe- 
trosal. They receive the inferior anterior cerebral veins, 
communicate with the petrosal sinuses, and receive the 
ophthalmic vein. They are connected with each other by 
the circular and transverse sinuses. 



VEIXS. 107 

Circulir.— The circular surrounds the pituitary body and 
communicates with the cavernous sinuses. 

Inferior Petrosal. — Each inferior petrosal is placed in a 
groove between the petrous part of the temporal bone and 
the basilar process of the occipital, and is the continuation 
of the cavernous backwards to the jugular foramen. Here it 
unites with the lateral sinus, and gives origin to the internal 
jugular vein. 

Transverse. — The transverse crosses the basilar process 
near its anterior end, and connects the two inferior petrosal 
sinuses together. 

Superior Petrosal. — Each superior petrosal runs along the 
groove in the upper edge of the petrous part of the temporal 
bone, to the sides of which the tentorium is attached. It 
connects the cavernous with the lateral sinus and receives 
the anterior lateral cerebellar, and, occasionally, the inferior 
lateral cerebral vein. 

veins of the upper extremity. 

The superficial veins are • 

Anxerior ulnar, Cephalic, 

Posterior ulnar, Median, 

Basilic, Median basilic, 

Radial. Median cephalic. 

Anterior Ulnar. — The anterior ulnar, arising from the 
front of the ulnar side of the hand, runs up the inner side 
of the foramen to the elbow, where it joins the posterior 
ulnar and forms the basiiic. 

Posterior Ulnar. — The posterior ulnar, starting upon the 
ulnar portion of the back of the hand, ascends upon the 
posterior surface of the forearm to meet the anterior ulnar 
and form the basilic vein. 

Basilic. — The basilic, formed by the two ulnar veins, 
pierces the deep fascia and runs up the inner side of the arm, 
along the brachial artery, to empty into the accompanying 
veins of the artery, or into the axillary. It receives the 
median basilic. 

Radial. — The radial originates on the surface of the 
thumb and first finger and radial side of the hand, and 
passes up the outer side of the forearm to the elbow, where 
it joins with the median cephalic and forms the cephalic 
vein. 

Cephalic. — The cephalic commences at the bend of the 
elbow, ascends the arm external to the biceps, and then 



108 COMPEND OF ANATOMY. 

runs between the Great pectoral and Deltoid muscles, to 
enter the axillary vein under the clavicle. It sometimes 
communicates with the external jugular. 

Median. — The median returns the blood from the palm 
of the hand and front of the forearm, extending to the 
elbow, where it receives a communicating branch irom the 
deeper veins, and terminates in the median cephalic and 
median basilic veins. 

Median Cephalic. — The median cephalic passes upwards 
and outwards, to make, with the radial, the cephalic vein. 

Median Basilic. — The median basilic runs upwards and 
inwards, to meet the basilic. Branches of the internal cu- 
taneous nerve pass in front of and behind this vein, and it 
is separated from the brachial artery beneath by the bicipi- 
tal fascia. 

The deep veins of the upper extremity accompany 
the corresponding arteries, and are usually two in number, 
placed one on each side of the artery, and frequently joined 
by transverse branches. The small veins are not of suffi- 
cient importance to jurtify further description. 

Axillary. — The axillary, formed by the continuation of 
the basilic, curves upwards and inwards, through the lower 
and front part of the axilla, to outer border of the first rib, 
where it becomes the subclavian. It receives branches cor- 
responding with those coming from the artery, and lies to 
the inner side of that vessel. 

Subclavian. — The subclavian commences where the axil- 
lary ends, at the outer border of the first rib, and terminates 
behind the sterno- clavicular articulation by joining the in- 
ternal jugular. The two thus form the innominate vein. 
The subclavian vein lies in front of the artery and Anterior 
scalene muscle, and is joined by the external and anterior 
jugular veins. 

Right Innominate. — The right innominate, about one 
inch and a half long, extends from the sterno clavicular 
articulation to a point behind the lower border of the fir:t 
costal cartilage, where it unites with the left innominate 
and forms the superior vena cava. It lies internal to and 
more superficial than the innominate artery. Its branches, 
all of the right side, are- 
Vertebral, Internal mammary, 
Inferior thyroid, Superior intercostal. 
It also receives the right lymphatic duct. 

Left Innominate. — The left innominate, larger than the 



VEINS. 109 

right and about twice as long, commences behind the 
inner end of the clavicl-3 and runs transversely across the 
chest in front of the large branches of the aorta, to meet the 
vein of the right side and give rise to the superior vena 
cava. It receives the same branches from the left as the 
right innominate does from the right side of the body. On 
this side of the body the lymphatic duct (thoracic duct) 
opens into the subclavian vein. The innominate veins have 
no valves. 

Internal Mammary. — The internal mammary veins, 
placed one on each side of the artery, unite and empty into 
the innominate. 

Inferior Thyroid. — The inferior thyroid veins, often three 
or four in number, commence in the plexus of veins about 
the thyroid body and descend the neck, near the middle 
line, to the innominate vein. 

Superior Intercostal. — The superior intercostal veins 
accompany the artery and return the blood from the upper 
two or three intercostal spaces. They terminate in the 
innominate veins, and that of the left side receives the left 
bronchial vein. 

Superior Vena Cava. — The superior vena cava, between 
two and three inches in length, is formed by the union of 
the two innominate veins and returns to the heart all the 
blood from the upper portion of the body. From the lower 
border of the first costal cartilage of the right side it passes 
directly downwards to the right auricle. It is joined by the 
great azygos and several pericardial veins, and has no valves. 
The three azygos veins connect the two venae cavaa and 
take the place, as it were, of these vessels in the region 
where the heart is located. 

Great Azygos Vein. — The right, or great, azygos vein is 
formed by a branch from the lumbar veins on a level with 
the first or second lumbar vertebra, whence it ascends 
along the right side of the spinal column, and passes 
through the diaphragm, with the aorta and thoracic duct, 
to the third dorsal vertebra, opposite which it enters the 
superior vena cava. Its branches are as follows : — 

Intercostal (lower ten of right side), 

Smaller azygos, 

(Esophageal, 

Mediastinal, 

Vertebral, 

Right bronchia. 



110 COMPEXD OF AX ATOMY. 

Smaller Azygos. — The left lower, or smaller, azygos vein 
originates in the renal or left lumbar veins, and, piercing 
the left cms of the diaphragm, rises to the sixth or seventh 
dorsal vertebra, where it turns obliquely to the right and 
enters the great azygos vein. It receives the lower inter- 
costal and some oesophageal and mediastinal veins. 

Left Upper Azygos {smallest). — The left upper, or small- 
est, azygos vein collects the blood from the two or three 
spaces not drained by the superior intercostal or the smaller 
azygos. It terminates in the great or lesser azygos vein. 

Bronchial. — The bronchial veins originate in the lung 
substance. The one on the right side empties into the 
great azygos ; that on the left terminates in the super-inter- 
costal vein. 

SPIXAL YEIXS. 

There are four sets of spinal venous plexuses — 

1. Outside the spinal column (dorsi- spinal). 

2. Between the vertebras and the membranes of the cord 
(meningo-rachidian) . 

3. In the bodies of the vertebrae. 

4. In the membranes of the cord (medulli-spinal). 

1. The dorsi- spinal veins originate in the muscles and 
integument behind the spinal column, and, after communi- 
cating with the veins of the adjacent vertebras, empty into 
the vertebral, the intercostal, the lumbar or the sacral, 
according to the regions they occupy. 

2. The anterior and posterior longitudinal spinal veins 
extend through the spinal canal, lying upon its anterior 
and posterior walls. They connect the dorsi-spinal veins 
and join the vertebral, intercostal, lumbar and sacral veins. 

3. The veins of the bodies of the vertebras arise in the 
substance of the bodies and converge to form one trunk, 
which escapes backwards into the anterior longitudinal 
spinal veins. 

4. The veins of the spinal cord, or the medulli-spinal 
veins, extend over the surface of the cord between the pia 
mater and the arachnoid. At the intervertebral foramina 
they terminate in the other veins from the canal. 

THE YEIXS OF THE LOWER EXTREMITY. 

The veins of the lower limb are arranged, as those of the 
upper, in a superficial and a deep set. The latter follow 
the course of the arteries and constitute their accompany- 
ing veins, or venae comites. 



VEINS. Ill 

The superficial veins are — 

Internal, or Long saphenous, 
External, or Short saphenous. 

Internal Saphenous. — The internal saphenous commences 
upon the dorsum and inner side of the Foot, runs in front of 
the inner malleolus and behind the inner condyle to the 
saphenous opening. In the leg, it lies behind the inner 
border of the tibia with the internal saphenous nerve ; in 
the thigh it ascends towards the saphenous opening, pierces 
the cribriform fascia and empties into the femoral vein 
about an inch an I a half below Poupart's ligament. 

Its chief branches are — 

Superficial epigastric, 
Superficial circumflex iliac, 
Superficial external pudic. 

External Saphenous. — The external saphenous vein origi- 
nates upon the upper and outer sides of the foot and passes 
behind the outer ankle. It ascends the leg with the ex- 
ternal saphenous nerve, first along the outer side of the 
tendon of Achilles, and then up the middle of the posterior 
surface to the popliteal space, where it opens into the pop- 
liteal vein. 

The deep veins of the lower extremity. — Plantar. — ■ 
The external and internal plantar veins follow the corre- 
sponding arteries, and unite to form the accompanying 
veins of the posterior tibial artery. 

Posterior Tibial. — The posterior tibial veins pass up the 
leg with the artery, receive the peroneal veins, and join the 
anterior tibial to form the popliteal. 

Dorsal of Foot, — The dorsal veins accompany the dorsal 
artery of the foot. 

Anterior Tibial. — The anterior tibial are continuations of 
those with the dorsal artery of the foot. In the upper portion 
of the leg they pass backwards and meet the posterior tibial, 
giving rise to the popliteal vein. 

Popliteal. — The popliteal, formed by the union of the 
anterior and posterior tibial veins, passes upwards through 
the popliteal space to the opening in the Great adductor, 
beyond which it is called the superficial femoral. It lies in- 
ternal to the artery below, but soon crosses it and becomes 
external above. It receives branches corresponding to those 
of the popliteal artery. 

Superficial Femoral. — The superficial femoral vein is the 
continuation of the popliteal, and ascends the thigh to the 



112 COMPEXD OF ANATOMY. 

point below Poupart's ligament, where the deep femoral 
joins it. It follows the artery, lying external lo it below, 
but finally getting behind it. 

Deep Femoral. — The deep femoral joins the superficial 
femoral to form the common femoral. 

Common Femoral. — This vein is formed by the deep 
femoral and the superficial femoral, and lies to the inner 
side of the common femoral artery. It terminates under 
Poupart' s ligament in the external iliac vein. Between it 
and Gimbernat's ligament is the internal femoral ring. The 
femoral veins receive branches corresponding to those given 
off by the arteries of the same name. 

External Iliac. — The external iliac extends from Pou- 
part's ligament upwards and inwards, to a point opposite 
the sacro iliac symphysis, where it joins the internal iliac 
and makes the common iliac vein. On the right side it lies 
first internal to, and then benea'h, the artery. On the left 
side the vein is in f ernal throughout. Its branches are the 
superficial and deep epigastric, and circumflex iliac veins. 
It has no valves. 

Internal Iliac — The internal iliac is formed by the coales- 
cence of the venae comites of the branches of the internal iliac 
artery. It lies at first inside the artery and then behind it. 
The blood is, therefore, returned by these venous branches 
from within and without the pelvis. 

Common Iliac. — The common iliac, formed by the junc- 
tion of the external and internal iliac veins, extends f, om 
the sacro-iliac symphysis to the level of the intervertebral 
cartilages between the fourth and fifth lumbar vertebrae, 
where the two common iliacs form the inferior vena cava. 
On the right side, the vein ascends in an almost vertical 
direction, while on the left it crosses more obliquely towards 
the right, and is longer. AU the iliac veins lie to the inner 
side of the corresponding arteries, excepting the common 
iliac of the right side, which is partially external to the ac- 
companying artery. The common iliac veins receive the 
ilio-lumbar, and sometimes the lateral sacral veins. The 
middle sacral generally terminates in the left common iliac. 

Inferior Vena Cava. The inferior vena cava collects the 
blood from all portions of the body below the diaphragm. 
Commencing at the right of the cartilage between the fourth 
and fifth lumbar vertebrae, where the common iliacs unite, 
the vena cava ascends in front of the spinal column and to 
the right of the aorta. It pierces the tendon of the dia- 



VEINS. 113 

pliragm and opens into the right auricle. The inferior vena 
cava receives the following veins : — 

Lumbar, 

Right spermatic (left goes to left renal), 

Ovarian (in the female), 

Renal, 

Right supra- renal (left emptying into renal), 

Right inferior phrenic (left going to renal), 

Hepatic (formed from intra-lobular by sub-lobular veins). 

These branches require little description, as they corres- 
pond closely with the arteries. These phrenic veins are 
called inferior, because there are superior phrenic veins on 
the upper surface of the diaphragm accompanying the 
phrenic nerve. 

The relative position of the large veins of the trunk may 
be recollected by the general rule that those above the dia- 
phragm lie in front of their arteries, while those below it, 
except the renal, lie behind. 

THE PORTAL SYSTEM. 

The portal system of veins comprises: — 

Inferior mesenteric, Splenic, 

Superior mesenteric, Gastric, 

which collect the blood from the digestive organs and the 
spleen and carry it to the liver. 

Mesenteries. — The inferior and superior mesenteric veins 
collect the blood from the intestines by means of branches 
corresponding to those of the mesenteric arteries. They 
accompany these arteries, and the superior, after receiving 
the right gastro- epiploic vein, joins the splenic to make the 
portal ; while the inferior terminates in the splenic vein. 

Splenic. — The splenic, commencing in the substance of 
the spleen, runs horizontally inwards to form, with the 
superior mesenteric, the portal vein. It receives 
Yasa brevia, Pancreatic, 

Left gastro- epiploic, Pancreatico- duodenal, 
and Inferior mesenteric. 
Portal Vein. — The portal vein (vena portae, not vena 
porta), formed by the union of the superior mesenteric and 
splenic veins, ascends through the lesser omentum behind 
the hepatic artery and duct to the liver, which it enters by 
the transverse fissure. It is about four inches long, and 
divides, first, into two branches. These further subdivide, 
following the ramifications of the artery and duct, to become 



114 



COMPEXD OF ANATOMY. 



the inter-lobular veins. Besides a small branch, the cystic, 
it receives the gastric vein. 

GastHc. — The gastric runs, with the gastric artery, upon 
the lesser curvature of the stomach from left to right to 
join the portal vein. 

The formation of the portal vein will be understood by 
this table : — 

Middle colic, 

Right colic, 

Ileo- colic, }- superior 

Small intestinal, mesenteric. 

Right gastro- epiploic 



Inferior mesenteric, 

Yasa brevia, 

Left gastro-epiploic, 

Pancreatic, 

Pancreatico- duodenal, 



splenic. 



PORTAL VEIN. 

branches, 
gastric, 
cystic. 



These 



CARDIAC VEINS. 



Great cardiac, Anterior cardiac, 

Posterior cardiac, Veins of Thebesius. 

TJie great cardiac runs in the anterior interventricular 
groove from the apex to the base of the ventricles, where it 
curves around in the auriculo-ventricular groove to the 
back of the heart and becomes the coronary sinus. It has 
valves at its opening into this sinus. 

The posterior cardiac also commences at the apex but 
ascends along the posterior interventricular groove and 
terminates in the coronary sinus. 

The anterior cardiac veins, three or four in number, 
extend from the surface of the right ventricle and open into 
the right auricle. 

The Veins of Thebesius are a number of small vessels, 
returning the blood from the substance of the heart and 
emptying separately into the right auricle. 

The Coronary Sinus is the continuation of the great car- 
diac vein, and lies in the posterior portion of the left auri- 
culo-ventricular groove. It is about an inch long, and enters 
the right auricle, being furnished by a fold of endocardium 
called ihe coronary valve. It receives the great cardiac, 
posterior cardiac, and some smaller veins. 



VEIN'S. 115 

THE LYMPHATICS, OR ABSORBENTS. 

The lymphatic system includes the lymphatic glands and 
the lymphatic and lacteal vessels. The lacteals are the 
lymphatic vessels of the small intestine, and carry not only 
lymph but the chyle, which gives them a white color. The 
other lymphatics carry lymph only. The lymphatic vessels 
are delicate, transparent tubes, furnished with valves like 
the veins. They have been found in nearly every structure, 
but their presence has not been proved in bone, cartilage, 
tendon, nor in the brain and spinal cord substance. They 
are arranged in superficial and deep groups ; and begin as 
plexuses, which empty into larger vessels, and these into 
still larger, until the largest lymphatic ducts open into the 
venous system by the subclavian veins. The lymphatic 
glands are situated in the course of the lymphatic vessels, 
especially in the neck, axilla, groin, mesentery, along the 
great vessels of the abdomen, and in the mediastinal spaces. 
The larger vessel, before entering a gland, breaks up into 
little branches, called afferent vessels ; these form a plexus 
within the gland, and then combining together, make their 
exit as a few efferent vessels, which finally coalesce to make 
a larger trunk. 

The lymph and chyle are conveyed into the blood current 
by the right and left lymphatic ducts. The left is much the 
larger, and is usually called the thoracic duct. It carries 
the chyle, and the lymph from the greater part of the 
organism. 

Thoracic Duct. — This is the great channel for the chyle, 
and for the lymph from every part of the body, except the 
right arm, right side of head, neck, and chest, and upper 
surface of liver. The right lung, and right side of the heart 
are included in the lymphatic distribution of the right side, 
but the left lung and left side of the heart have lymphatics 
terminating in the thoracic duct. The thoracic duct begins 
in the receptacle for chyle (receptaculum chyli), which lies 
in front of the second lumbar vertebra, to the right of, and 
behind the aorta. The duct goes up through the aortic 
opening in the diaphragm, continues in front of the spine 
in the posterior mediastinum, and at the level of the fourth 
dorsal vertebra inclines to the left of the column, keeping 
behind the aorta. It continues to ascend until, at the upper 
edge of the seventh cervical, it curves forwards and down- 
wards, and, passing in front of the Anterior scalene muscle, 
discharges its contents into the subclavian vein at its angle 



116 COMPEND OF ANATOMY. 

of junction with the internal jugular. It has valves through- 
out its course, especially at the upper part. It receives the 
lymphatic trunks coming from all parts of the body and 
limbs, with the exceptions mentioned above. 

Bight Lymphatic Duct. — This is only an inch long, and, 
after receiving the vessels from the right arm, the right 
side of head, neck and chest, and the upper surface of the 
liver, empties into the right subclavian at its union with the 
internal jugular. Its orifice is guarded by valves also, to 
prevent regurgitation of blood from the vein. 

Lymphatic Glands and Small Vessels. — These are named 
from the regions in which they are located, and do not need 
detailed description. Thus we have occipital, posterior au- 
ricular, submaxillary, cervical, mediastinal, axillary, sacral 
and lumbar lymphatic glands j and lymphatic vessels corres- 
ponding. 



NERVOUS SYSTEM. 117 



CHAPTER V. 



THE NERVOUS SYSTEM. 

The nervous system comprises the cerebro-spinal system 
and the sympathetic system. The former is often called 
the system of animal life, because it presides especially over 
the functions of locomotion, volition, sensation, etc.; the 
latter that of organic life, since the functions of nutrition 
and growth seem to be under its sway. Each of these sys- 
tems is made up of gang ia and nerves, which are composed 
of the three varieties of nervous tissue. 

The principal part of the nervous system consists of the 
two forms of structuie called the gray or vesicular, and the 
white or fibrous. The gray nervous tissue is supposed to 
be that in which the nervous impulses and impressions origi- 
nate, while the white acts as a conductor for such impulses 
and impressions. This may be illustrated by calling the 
gray or vesicular matter the galvanic battery ; the white or 
fibrous portion, the telegraph wires. There is, however, a 
third form of nervous matter, found especially in the sympa- 
thetic system and in the olfactory nerve, which is called the 
gelatinous (fibres of Remak). As there is still a difference 
of opinion as to the true nature of this tissue, it is less im- 
portant than the two forms mentioned above. 

The gray, or vesicular, nervous tissue is found in the 
middle of the spinal cord, the surface of the brain and in the 
ganglia, but not in the nerves. It c msists of corpuscles, or 
vesicles of various forms, containing nuclei and nucleoli. 
The white or fibrous tissue is found in the exterior of the 
cord, the interior of the brain, in the nerves, and in a great 
part of the sympathetic system. It is composed of a series 
of tubes, each of which has an axis-cylinder, surrounded by 
the white substance of Schwann, and enclosed in the tubular 
membrane. The white substance is supposed to be fluid fat, 
and serves to protect the axis- cylinder, which is the true con- 
ductor. It will be seen that the axis-cylinder resembles the 
delicate telegraph wire of copper enclosed in rubber insulating 
material, and surrounded by a protecting sheath. Many of 



118 COMPEND OF ANATOMY. 

these tubes placed side by side form a bundle, and these 
bundles are placed together to form larger or smaller nerves. 
The investment around the bundles is called the neuri- 
lemma, or perineurium. Ihe completed nerves them&elves 
have also a sheath. As a nerve runs to a ganglion, or 
towards a single cell or vesicle, it splits up into its ultimate 
nerve tubules, and each of these loses its white substance and 
probably joins the cell as a simple axis-cylinder. 

It is necessary that the nervous tissue be held together 
whenever it is massed, as in the brain and cord; hence, it 
is supported and joined by a network of connective tissue, 
called the neuroglia, or " nerve glue." 

The ganglia, found throughout various parts of the nervous 
system, are independent nerve centres, similar to, but much 
less complex than the brain. They consist of gray substance 
traversed by nerve fibres, either tubular or gelatinous. 

A plexus is a communication between several nerves, 
where their branches, by joining and separating, have their 
fibres intermingled. A sensory, centripetal, or afferent 
nerve transmits nervous impressions from the peripheral end 
towards a centre, such as the brain. A motor, centrifugal, 
or efferent nerve transmits impulses from the centre towards 
the parts to which the nerve is distributed, and thus causes 
motion, secretion, etc. 

Sensory nerves terminate as minute plexuses, as end 
bulbs of Krause, tactile corpuscles of Wagner, and Pacinian 
corpuscles. In special organs their terminations are more 
complex and still less perfectly understood. Motor nerves 
terminate in muscles as plexuses, or in motorial end plates. 
The central termination of nerves has not been made out, 
though it seems probable that the axis cylinder terminates 
in a vesicle of the gray matter. 

THE CEREBROSPINAL SYSTEM. 

This system, called also the nervous system of animal 
life, consists of, 1, the brain and spinal cord, termed the 
cerebro-spinal centre or axis ; 2, the ganglia, situated upon 
some of the nerves ; and 3, the nerves. 

MEMBRANES OF THE SPINAL CORD. 

We shall consider the cord and its membranes before the 
brain, because it is much more readily understood. The 
cord, surrounded by its membranes, lies in the spinal canal 



NERVOUS SYSTEM. 119 

foimed by the vertebrae and their ligaments. The mem- 
branes are : 1, the outer or dura mater, a fibrous structure; 

2, the middle or arachnoid, which is serous tissue ; and 

3, the inner or pia mater, which is a vascular membrane. 
The relative position of ihese coverings may be recollected 
by the word PAD, the first letter signifying the internal 
membrane. 

Dura Mater. — This covering extends from the foramen 
magnum of the occipital bone, to the edge of which it is 
fastened, to the coccyx, where it, after becoming a mere 
cord, is attached to the periosteum on the back of this bone. 
It is continuous with the dura mater of the brain, and forms 
sheaths for the spinal nerves. It differs from the similar 
covering of the brain, because it does not serve as an in- 
ternal periosteum, nor form sinuses or partitions. 

Arachnoid. — This is a serous sac, having a parietal layer, 
lining the inner surface of the dura mater, and a visceral 
layer, covering the pia mater and the cord. This is, to my 
mind, the simpler method of describiDg the structure, though 
some believe that there is really no parietal byer next to the 
dura mater, but state that the inner surface of the dura 
mater is merely covered by a layer of epithelium. Between 
the arachnoid and the pia mater is the sub-arachnoid space ; 
the arachnoid cavity is between the two layers of arach- 
noid. 

Pia Mater. — This is chiefly a vascular covering, and is 
closely attached to the surface of the cord, sending delicate 
processes into the anterior and posterior fissures. At the 
lower end of the cord the pia mater is continued downwards, 
as a narrow thread. This is called the terminal filament 
(filum terminale), and joins the dura mater. On each side 
of the cord, between the anterior and posterior roots of 
spinal nerves, extends a serrated band, which stretches from 
the pia mater to the dura mater, thus uniting the two layers 
of arachnoid at each point of serration. This is called the 
dentated ligament, or lateral ligament, of the cord, while the 
terminal filament spoken of is the central ligament. These 
maintain the cord in position as it floats in the sub arachnoid 
fluid. 

SPINAL CORD. • 

The spinal cord, or marrow, is about sixteen inches long, 
and weighs one and a half ounces ; it does not fit the canal 
tightly, and only extends through two- thirds of the length 



120 COMPEND OF ANATOMY. 

of the bony canal. It floats in the sub-arachnoid fluid and 
moves up and down, during flexion and extension of the 
back. The cord proper terminates at the lower edge of the 
first lumbar vertebra ; it presents an enlargement where 
the nerves forming the brachial plexus are given off, and 
another at the origin of the lumbar and sacral plexuses. 
The nerve roots going to these last two plexuses are contained 
in the spinal canal, before reaching their respective inter- 
vertebral foramina, and constitute the so-called horse-tail 
(cauda equina). 

The structure of the cord is seen by a transverse section, 
which shows that the white matter constitutes the exterior 
and the gray matter the interior of the organ. The gray 
matter, in a transverse section, has somewhat the appear- 
ance of a letter iJwith crescentic sides, and with the pos- 
terior arms longer and more narrow than the anterior arms. 
The horns of gray matter and the connecting band, or gray 
commissure, differ, relatively, in shape in different regions 
of the cord. 

Fissures. — The anterior median fissure runs down the 
front, and the posterior median fissure down the back of the 
cord. The lateral halves so formed are divided into ante- 
rior, Jateral and posterior columns by two grooves, from 
which the anterior and posterior roots of spinal nerves arise. 
These fissures are called right and lefl antero-lateral, and 
right and left postero -lateral fissures. On each side of the 
posterior median fissure there is- a small groove, without 
special name, which gives rise to the existence of the small 
posterior median column f really a part of the posterior 
column. 

Columns. — The columns, then, are: 1, the anterior, which 
is continuous with the anterior pyramid of the medulla 
oblongata ; 2, the lateral, continuous with the lateral tract 
and olivary body of the medulla oblongata ; 3, the pos- 
terior, continuous with the restiform body; and 4, the 
posterior median column becoming the posterior pyramid 
of the medulla oblongata. The anterior and lateral columns 
are sometimes denominated together the antero-lateral col- 
umn, because the line of division is very indistinct. 

Canal, or Ventricle, of the Cord. — In the foetus, until the 
sixth month, and sometimes in adults, there is seen a cen- 
tral canal extending the whole length of the cord. This is 
continuous with the fourth ventricle of the brain, and is 



NERVOUS SYSTEM. 121 

called the canal of Stilling or the ventricle of the cord. Its 
remains can always be seen at the top of the cord. 

MEMBRANES OF THE BRAIN. 

The membranes of the brain are similar in name and 
structure to those of the cord. 

Dura Mater. — The dura mater of the brain, however, 
forms the internal periosteum of the cranial bones, separates 
its layers to form the sinuses described under the venous 
system, and is reflected to form certain partitions between 
various portions of the brain. It is a fibrous membrane, 
and has upon its surfaces near the superior longitudinal 
sinuses the Pacchionian bodies, which are rare in infancy, 
and whose function is unknown, The processes, or parti- 
tions, formed by the dura mater are: the falx cerebri, 
between the two hemispheres of the brain ; the tentorium 
cerebelli, which is horizontal and lies between the cerebrum 
and cerebellum ; and the falx cerebelli, reaching vertically 
from the lower surface of the tentorium to the foramen 
magnum, and thus separating the two hemispheres of the 
cerebellum. 

Arachnoid. — This is the middle or serous covering, and 
has a visceral and a parietal layer. Where it stretches across 
the base of the brain, between the middle lobes and in front 
of the pons Varolii, the visceral layer has beneath it the 
anterior sub-arachnoid space. Where it extends from the 
cerebellum to the medulla oblongata is found the posterior 
sub arachnoid space. 

Pia Mater. — The pia mater contains the small vessels, and 
covers and dips between the convolutions. It gives off 
through the transverse fissure of the brain a process, which 
enters the interior of the brain and becomes the velum in- 
terpositum. 

BRAIN. 

The brain, or encaphalon, consists of the cerebrum, which 
is nearly seven-eighths of the whole, the cerebellum, the 
medulla oblongata, and the pons Varolii. The weight of 
the male brain is fifty ounces, of the female, forty-five 
ounces avoirdupois. 

' As the spinal cord has been described already, it will be 
well to discuss first the medulla oblongata, which is the 
continuation of the cord, and resembles it in its general 
anatomy. 



122 COMPEND OF ANATOMY. 

MEDULLA OBLONGATA OR BULB. 

The shape of this portion of the brain is pyramidal, with 
its base upwards. Its length is one and a quarter inches. It 
lies upon the basilar process of the occipital bone, extend- 
ing from the pons Varolii down to the foramen magnum. It 
has an anterior median fissure like the spinal cord ; and at 
the upper part of the fissure the decussation, or crossing, of 
the fibres of the two sides is seen. The posterior median 
fissure gradually widens and reveals the flow of the fourth 
ventricle of the brain. The surface is divided on each side 
into the anterior pyramid, lateral tract and olivary body, 
restiform body, and posterior pyramid. 

The anterior pyramid, is a continuation upwards of the 
anterior column of the cord, and lies between the anterior 
median fissure and the olivary body. Its inner fibres and 
the deep fibres of the lateral columns of the cord are seen to 
decussate with those of the opposite pyramid. 

The lateral tract below is wide and corresponds with the 
lateral column of the cord, but above it becomes narrowed 
by the insertion of the olivary body between it and the ante- 
rior pyramid. The olivary body is an oval projection, half 
an inch in length, lying between the parts just mentioned. 
On section it is found to be a ganglionic mass, containing a 
nucleus called the dentate body. 

The restiform or "rope- shaped" body is continuous with 
the posterior column of the cord. In the upper part of the 
medulla oblongata the two restiform bodies diverge, and 
enter the cerebellum, receiving the name inferior peduncles 
of tho cerebellum. 

The posterior pyramid corresponds with the small portion 
of the spinal cord called the posterior median column. It 
consists entirely of white fibres. The two diverge to form 
the lower angle (calamus scriptorius) of the fourth ven- 
tricle. 

The posterior surface of the medulla oblongata forms a 
portion of the floor of the fourth ventricle, as will be under- 
stood when it is said that this ventricle lies above the 
medulla oblongata and below the cerebellum. The gray 
matter seen in the floor of this cavity is continuous with the 
gray matter of the cord. At the lower ansle is seen the 
opening into the cord, called the canal of Stilling, the 
ventricle of Arantius, or, best of all, the ventricle of the 
cord. 



NERVOUS SYSTEM. 123 

The course of the fibres of the medulla oblongata is com- 
plicated, and not completely made out by physiologists, 
though some points are now well established. 

PONS VAROLII. 

This body is aptly termed the bridge of Yarolius, for it 
joins the cerebellum, cerebrum and medulla oblongata to- 
gether. It lies in front of, and between the two halves of 
the cerebellum, and is about an inch and a half from side to 
side. Its fibres on the surface run transversely, and thus 
it resembles a bridge from one hemisphere of the cerebellum 
to the other. Its connection with the cerebellum forms on 
each side the middle peduncle of the cerebellum. Its an- 
terior surface is grooved for the basilar artery ; its posterior 
forms the floor of the upper part of the fourth ventricle. It 
consists of layers of transverse and longitudinal fibres and 
an intermingling of gray matter. The former connect the 
two halves of the cerebellum ; the latter are continued up 
from the spinal cord and medulla oblongata, principally to 
the cerebrum. 

CEREBRUM. 

This, the largest portion of the brain, is formed of two 
lateral halves or hemispheres, separated by the longitudinal 
fissure, in which the faix cerebri is situated. In front the 
separation is complete, but behind the hemispheres are 
united at the bottom of the fissure by the white corpus 
callosum. 

Unfortunately the topography of the cerebrum, and indeed 
of the whole eucephalon, is burdened with many difficult 
Latin names. It is impossible to use the English synonyms, 
because they would be so unlike the Latin and so unfamiliar 
that it would only increase the confusion. I shall endeavor 
to elucidate the subject by employing as few Latin names as 
possible, and by omitting all mention of unimportant locali- 
ties, even though they have long titles. 

The surface, or cortical substance, of the cerebrum con- 
sists of gray matter, and is marked by deep, irregular fur- 
rows, dividing it into convolutions. These furrows are more 
readily traced when the pia mater has been carefully re- 
moved. The convolutions (or gyri) and the fissures (or sulci) 
greatly increase the gray surface of the brain, and are more 
marked in the higher animals than in the lower, and in the 
adult than in the child. 



124 COMPEXD OF AXATOMY. 

There are five lobes of tlie cerebrum. : 1, the frontal, 
2, parietal, and 3, occipital, named after the overlying 
cranial bones ; 4, the temporo-sphenoidal, below the hori- 
zontal branch of the fissure of Sylvius and lying in the 
depression made by temporal and sphenoid bones ; and 5, the 
triangular island of Rett, lying at the bifurcation of the fis- 
sure of Sylvius and covered by the overhanging frontal and 
temporo sphenoidal lobes. 

These lobes are divided by various fissures into the convo- 
lutions above mentioned, and there is a general iesemblance 
in regard to the outlines of the convolutions in all human 
brains. Hence many of the fissures and convolutions have 
been named. The most constant and important should be 
learned. 

Fissures. — The longitudinal fissure on the convexity di- 
vides the cerebrum into two laterai'hemisplieres and receives 
the falx cerebri. The fissure of Sylvius, lying at the base, 
separates the frontal and temporo-sphenoidal lobes, and 
divides into an ascending and a horizontal branch. It thus 
forms also the division, more or less distinct, between the pari- 
etal and temporo-sphenoidal lobes. The fissure of Rolando 
runs downwards from the longitudinal fissure towards the 
posterior part of the Sylvian fissure, and separates the frontal 
and parietal lobes at their upper part. The line of division 
between the parietal and occipital lobes is the parieto- 
occipital fissure, sometimes better marked on the inner sur- 
face of the hemisphere than on its convexity. On the inner 
surface is seen the calloso- marginal fissure, just above the 
convolution over the corpus callosum ; the ends of the fissure 
of Rolando and of the parieto- occipital fissure ; and a hori- 
zontal fissure joining the last, called the calcarine fissure. 

Convolutions. — On the upper and outer, or convex sur- 
face, we have the convolution of the longitudinal fissur°, 
running along the edge of the fissure and curving over the 
front and back of the hemisphere to the base of the cere- 
brum. In front of the fissure of Rolando is situated the 
ascending frontal convolution and behind it the ascending 
parietal convolution. These are the most important to re- 
member, because the names superior, middle and inferior 
frontal, superior, middle and inferior occipital, superior and 
inferior parietal, superior, middle and inferior temporo- 
sphenoidal are sufficiently explanatory. 

The island of Rett, a triangular portion, often called the 
fifth lobe, lies in the bifurcation of the fissure of Sylvius, and 



iiinmii 



NERVOUS SYSTEM. 125 

consists of a half dozen convolutions, called " covered con- 
volutions" (gyri operti), because overhung by the adjacent 
lobes. 

On the inner or flat surface of the hemisphere is seen the 
convolution of the corpus callosum, lying over the corpus 
callosum and following its curvature. It is frequently called 
the gyrus fornicatus. Above it runs the calloso-marginal 
fissure. On this same surface, between the end of the fissure 
of Rolando and the pari eto- occipital fissure, is the square or 
quadrate convolution, and between the parieto-occipital and 
the calcarine fissures, the wedge or euneate convolution. 

BASE OF THE CEREBRUM. 

The under surface of the cerebrum shows the end of the 
longitudinal fissure separating the right and lefc frontal lobes, 
the fissure of Sylvius on each side, separating the frontal 
from the temporo- sphenoidal lobe, and the flattened occipital 
lobes. The base of the brain is usually studied with the 
pons, medulla oblongata and cerebellum attached to the 
cerebrum, as a better idea of the relation of parts and of the 
origin of nerves is thus obtained. The vessels and mem- 
branes should be carefully removed, in order to see the parts 
to be described. The arterial circle of Willis has been fully 
discussed under the arteries. The prominent points at the 
base of the cerebrum are placed in the following list. I 
begin anteriorly and go back to the pons Varolii, already de- 
scribed, but omit the cranial nerves, to be discussed later : — 
Olfactory bulbs, Tuber cinereum, 

Corpus callosum, Infundibulum, 

Lamina cinerea, Pituitary body, 

Anterior perforated spaces, Corpora albicantia, 
Optic commissure, Posterior perforated space, 

Crura cerebri. 
Olfactory Bulbs, — These are oval bodies attached to the 
anterior part of the olfactory nerves, and lie one on each side 
of the longitudinal fissure, making depressions in the frontal 
lobes. 

Corpus Callosum. — The corpus callosum is seen curving 
around from the upper portion of the longitudinal fissure, as 
soon as the frontal lobes are separated. It is a white body 
and terminates at the lamina cinerea. Its bent portion is 
called the genu or knee. It has on each side a band run- 
ning towards the fissure of Sylvius called a peduncle. 



126 COMPEXD OF ANATOMY. 

Lamina Cinerea. — This is a layer of gray matter forming 
the anterior part of the floor of the third ventricle, and ex- 
tending backwards from the corpus callosum to the tuber 
cinereum. It is partly hidden by the optic commissure. 

Anterior Perforated Spaces. — The small vessels to the 
corpora striata, in the interior of the cerebrum, pass through 
a layer of gray matter at the beginning of the fissure of Syl- 
vius, and behind the roots of the olfactory nerve. These 
spaces are called anterior perforated spaces. 

Optic Commissure. — The two optic nerves join together 
like the two parts of a letter X. The point of crossing is 
called the optic commissure ; the parts behind, the optic 
tracts ; the portions in front, the optic nerves. The com- 
missure is situated over the lamina cinerea, when the brain 
lies upside down for examination. 

Tuber Cinereum. — This eminence of gray matter is situated 
behind the optic commissure, and forms part of the floor of 
the third ventricle. From it extends a funnel- shaped pro- 
cess, the infundibulum^ which is attached to the pituitary 
body. The cavity or canal of the infundibulum communi- 
cates with the third ventricle. The infundibulum and pitui- 
tary body are often torn away in removing the brain from 
the skull, and the tuber cinereum alone remains. 

The pituitary body is a gray vascular mass of two lobes 
lying in the sella Turcica, where it is held by the dura mater 
stretched across from the clinoid processes. It resembles in 
structure the ductless glands, and is attached to the base of 
the cerebrum by the infundibulum. 

The corpora albicantia (singular, a corpus albicans) are 
two white nodules lying behind the tuber cinereum and be- 
tween the crura cerebri. They are really the lower ends of 
the anterior crura of the fornix, which bend and then pass 
upwards to the optic thalami. A better name for them is the 
bulbs of the fornix. 

Posterior Perforated Space. — This space lies between the 
crura cerebri and behind the corpora albicantia, and admits 
the vessels going to the optic thalami. There is only one 
posterior, though there are two anterior perforated spaces. 

Crura Cerebri. — These peduncles of the cerebrum are 
two thick bundles of fibres extending from under the edge 
of the pons to the optic thalami. They diverge as they 
leave the pons, and leave the interpeduncular space in 
which lie the tuber cinereum, corpora albicantia and pos- 
terior perforated space, already described. They are 



NERVOUS SYSTEM. 127 

crossed by the optic tracts, and contain a gray nucleus 
called the locus niger. They consist of the fibres of the 
cord and medulla oblongata, continuing upwards to the 
cerebrum. 

INTERIOR OF THE CEREBRUM. 

The general structure of the cerebrum will be understood 
by this description : The two peduncles diverge, enter the 
cerebrum, and pass to the great ganglia of the brain, of 
which there are two in each hemisphere. The anterior is 
the striated body (corpus striatum), the posterior the optic 
bed (thalamus opticus). In a general way it may be said 
that the motor fibres of the cord and peduncle come from 
the striated body, the sensory fibres go to the optic thalamus. 
The two hemispheres of the cerebrum are joined by the cor- 
pus callosum, which is composed of transverse fibres and 
acts like a bridge. This stretches from side to side above 
the great ganglia. The cavity left below the corpus callosum 
and between the peduncles and ganglia of the two sides is 
the ventricular cavity. The upper part of this is divided into 
two lateral ventricles by the septum lucidum ; under these 
lies the third ventricle, separated from them by the fornix 
and velum interpositum, but communicating with them by 
the foramen of Monro. There is a small canal running 
from this third ventricle backwards to the fourth ventricle, 
previously stated as being above the medulla oblongata and 
below the cerebellum. This is the aqueduct of Sylvius. 
Within the septum lucidum is a small cavity called the fifth 
ventricle. 

DETAILS OF THE INTERIOR OF THE CEREBRUM. 

If the upper part of the hemispheres be removed with a 
scalpel, the white matter of the interior presents an oval 
surface, surrounded in each hemisphere by a border of gray 
matter. These are called the lesser oval centres. Between 
them is the remains of the longitudinal fissure, at the bottom 
of which lies the corpus callosum. The space between the 
top of the corpus callosum and the overhanging convolutions 
is sometimes called the ventricle of the corpus callosum. 
The name, however, tends to cause confusion and should 
be discarded. If the section is made on a level with the 
corpus callosum, the oval surface formed by the white matter 
cf th? two hemispheres and joined by the corpus callosum is 
called the greater oval centre. In the white matter so ex- 



128 COMPEND OF ANATOMY. 

hibited are numerous red points, caused by the incision 
dividing small vessels. 

The corpus callosum, the anterior end of which was seen 
at the base of the brain, is exposed by the last section. It 
is four inches in length, and in front curves around to the 
base of the brain. Its fibres run transversely and unite the 
two hemispheres. Its posterior end is attached to the 
fornix which lies underneath. Upon its upper surface are 
seen the median raphe and longitudinal striations. The 
innermost of these striations are improperly called nerves 
of Lancisi. 

The Lateral Ventricles. — These cavities are shown by 
cutting through the corpus callosum and the white sub- 
stance at its margins. They are lined by serous membrane, 
and each one has a central cavity and three prolongations, 
or horns. The anterior horn, or cornu, runs forwards into 
the anterior lobe of the cerebrum, the posterior into the pos- 
terior lobe, the middle or descending downwards into the 
middle lobe. The ventricles are separated from each other 
by the septum lucidum, a vertical partition extending from 
the corpus callosum down to the fornix. The roof of each 
lateral ventricle is formed partly by the corpus callosum ; 
the floor is made up of a number of structures, which I 
shall enumerate by beginning in front, They are the cor- 
pus striatum and optic thalamus, with the taema semicircu- 
laris between them, the choroid plexus, corpus fimbriatum, 
fornix, and greater and lesser hippocampus. 

Corpus Striatum. — This large motor ganglion is so called 
because a section shows it to consist of white and gray 
matter giving a striated appearance. It is an oval mass and 
lies partly in the floor of the lateral ventricle. and partly im- 
bedded in the white matter of the cerebrum. 

Tcenia Semicircularis. — This narrow band lies in the 
groove between the corpus striatum and the optic thalamus. 

The optic thalamus is the large sensory ganglion of the 
brain, and lies behind and to the inner side of the striated 
body. It forms the lateral boundary of the third ventricle, 
to be described hereafter, and lies upon the crus cerebri of 
the corresponding side of the brain. On its posterior and 
inferior portion are situated the geniculate bodies. 

The choroid plexus is a vascular membrane which emerges 
from under the edge of the fornix and can be seen descend- 
ing into the middle horn. It is the margin of the velum in- 
terpositum, which lies under the fornix and which is a . 



NERVOUS SYSTEM. 129 

portion of pia mater from the exterior of the brain. This 
process of pia mater enters the interior of the cerebrum 
through the transverse fissure, which is above the cerebel- 
lum. The choroid plexus of one side joins with that of the 
other through the foramen of Monro, which connects the 
two lateral ventricles and is situated behind the anterior 
peduncles of the fornix. 

The corpus fimbriatum is a name given to the edge of the 
fornix overlying the choroid plexus. 

Fornix. — This triangular structure lies under the corpus 
callosum ; behind they are continuous, but anteriorly they 
diverge from each other; on account of the fornix curving 
downwards. The vertical partition called the septum luci- 
dum is placed between their anterior portions. The fornix 
in front divides into two crura or peduncles, which pass to 
the base of the brain and form the corpora albicantia. The 
fornix posteriorly is continuous with the lesser hippocam- 
pus, an elevation lying in the posterior horn of the ventricle; 
and laterally with the greater hippocampus, an elevation 
descending into the middle horn and terminating as the pes 
hippocampi, or sea-horse's foot. Between the two hippo- 
campi is the collateral eminence, or accessory foot. 

Transverse section of the greater hippocampus shows it 
to be produced by one of the convolutions, that of the corpus 
callosum, doubling upon itself, so that the white convexity 
projects into the middle horn of the ventricle. The gray 
matter on the surface of this convolution can be seen by 
raising the edge of the corpus fimbriatum. This gray matter 
forms the so-called fascia dentata, which is really outside the 
cavity of the horn and belongs to the external surface of the 
hemisphere. On the inferior surface of the fornix are some 
lines resembling a harp, hence called the lyra. Under the 
fornix is seen the transvere fissure through which the pia 
mater enters to form the velum interpositum. 
' The fifth ventricle lies between the two layers of the sep- 
tum lucidum, and is a mere slit, lined with serous membrane. 
In the foetus the fifth ventricle communicates with the third 
ventricle below. 

The velum interpositum is the delicate veil stretched 
across the top of the third ventricle, and lying underneath 
the fornix. It is a portion of pia mater that has entered by 
the transverse fissure. On its edges are the choroid plexuses 
of the lateral ventricles, on its inferior surface the choroid 
plexuses of the third ventricle, and small arteries and veins. 



130 COMPEXD OF ANATOMY. 

The veins, veins of Galen as they are called, empty into the 
straight sinus. 

Third Ventricle. — The space or cavity beneath the velum 
interpositum and between the two optic thalami is called the 
third ventricle. Its floor is the lamina cinerea, the tuber 
cinereum and the adjacent structures, described with the 
base of the cerebrum. It is crossed by three bands or com- 
missures ; the anterior, of white matter, between the two 
striated bodies, the middle, or gray, commissure between 
the optic thalami, and the posterior, of white substance, 
between the optic thalami at the posterior end of the ven- 
tricle. There are four openings leading from the third 
ventricle. In front are the two openings into the lateral 
ventricles, constituting the foramen of Monro ; under the 
posterior commissure the aqueduct of Sjdvius, or the road 
from the third to the fourth ventricle 5 and in the floor the 
opening into the infundibulum. 

The foramen of Monro is the oval opening behind the 
anterior peduncles of the fornix, through which the choroid 
plexuses of the lateral ventricles join together, and by which 
communication between the third and the two lateral ven- 
tricles is established. 

The Pineal Gland and Corpora Quadrigemina. — Under 
the velum interpositum, and behind the posterior commis- 
sure, is seen a reddish-gray body lying upon four small 
elevations. It is the pineal gland, and the four elevations 
are called the corpora quadrigemina. The pineal gland is 
attached to the optic thalami by anterior peduncles, easily 
seen, and by inferior peduncles, which are only shown by 
making a vertical section. It consists of gray matter and 
vessels, and contains small concretions. It is said to have 
a small cavity within it. 

Corpora Quadrigemina. — These four bodies are located 
behind the third ventricle and over the canal between the 
third and fourth ventricle. The anterior are called the 
nates or buttocks, the posterior the testes or testicles. 
Between the testes and cerebellum run bands, between 
which lies the valve of Vieussens giving origin to the 
fourth pair of cranial nerves. The corpora quadrigemina 
are often called optic lobes, because the optic nerves have 
their origin in them. 

Structure of the Cerebrum. — The white matter of the 
hemispheres consists of diverging fibres coming from the 
cord, transverse fibres joining the two hemispheres, and 



NERVOUS SYSTEM. 131 

longitudinal fibres joining different parts of the same 
hemisphere. 

CEREBELLUM. 

The cerebellum lies in the occipital fossa, separated from 
the cerebrum by the tentorium. It consists of two hemi- 
spheres, marked by transverse fissures dividing the surface 
into layers. The upper surface presents a median ridge, 
called the superior vermiform process, which connects the 
hemispheres ; and each hemisphere is divided into an an- 
terior and posterior lobe. The lower surface is separated into 
the hemispheres by a median farrow, the bottom of which 
is the inferior vermiform process. This process is divided 
into three portions ; that in front is called the nodule, the 
posterior takes the name of the pyramid, the middle is the 
uvula. On each side of the uvula there is a projection of 
the hemisphere called the tonsil. The other portions of 
the hemisphere of importance are the posterior, slender, 
and digastric lobes ; and in front of the digastric lobe the 
flocculus, or sub-peduncular, lobe. This lies under the 
middle peduncle of the cerebellum. 

A vertical section of the cerebellum shows in the interior 
of each hemisphere the ganglion, or dentate body, consist- 
ing of gray matter ; and the peculiar arrangement of white 
and gray matter towards the surface, which is called the 
arbor vitae, because it resembles the branches of a tree. 

The cerebellum is attached to the cerebrum and medulla 
oblongata by three pairs of peduncles. The superior 
peduncles extend from the cerebellum to the testes ; the 
middle from the cerebellum to the pons Varolii ; the in- 
ferior from the cerebellum to the medulla oblongata, form- 
ing part of the restiform bodies. 

The fourth ventricle is the space between the lower sur- 
face of the cerebellum and the medulla oblongata. It is 
lozenge shaped, and has its sides formed by the converging 
superior peduncles of the cerebellum above and the diverg- 
ing posterior columns of the medulla oblongata below. Its 
floor is the posterior surface of the medulla oblongata and 
pons, its roof the valve of Yieussens and the cerebellum. 
It opens above into the third ventricle by the aqueduct of 
Sylvius (iter a tertio ad quartum ventriculum), and below, 
at the calamus scriptorius, it communicates with the canal, 
or ventricle, of the cord. In the floor on each side of the 
middle line are two longitudinal elevations called the fasci- 



132 



COMPEND OF ANATOMY. 



culi teretes ; outside of these lies a bluish-gray eminence 
called the locus caeruleus, or blue spot. The ventricle 
communicates with the subarachnoid space of the cord by 
an aperture in the pia mater crossing from the cerebellum 
to the medulla oblongata. Two vascular fringes projecting 
into the ventricle at the sides are called choroid plexuses 
of the fourth ventricle. From the upper part of the floor 
of the fourth ventricle the sixth and seventh nerves arise, 
and from its lower half the ninth, tenth, eleventh and 
twelfth nerves. 



CRANIAL, NERVES. 

There are twelve pairs of cranial nerves, all of which, 
arising from the encephalon, make their exit through open- 
ings in the base of the skull. The function of these nerves 
differs. Some of them are nerves of common sensation, 
some are nerves of motion, others are nerves of special 
sense, while a few partake of two characters and have 
branches with different functions. 



NUMBER. 


NAME. 


FUNCTION. 


First, 


Olfactory, 


Smell, 


Second, 


Optic, 


Sight, 


Third, 


Motor oculi, 


Motion, 


Fourth, 


Pathetic, 


Motion, 


Fifth, 


Trifacial or Trigeminal, 


Sensation (large 

root), 

Motion (small root), 

Taste (a small 

branch), 


Sixth, 


Abducent, 


Motion, 


Seventh, 


Facial, or Portio dura, 


Motion, 


Eighth, 


Auditory, or Portio mollis, 


Hearing, 


Ninth, 


Grlosso-pharyngeal, 


Sensation, 



Tenth, . Pneumogastric, or Parvagum, Sensation, 

Motion, 
Eleventh, Spinal Accessory, Motion, 

Twelfth, Hypoglossal, Motion, 

This numbering, proposed by Sommering, is the better, 
though some writers still adhere to the old method of Willis, 
who included the Facial and Auditory under the name of 
the seventh, and the Glosso-pharyngeal, Pneumogastric 
and Spinal accessory under the name of the eighth. The 
Hypoglossal then becomes the ninth. 



CRANIAL NERVES. 



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142 COMPEND OF ANATOMY. 

SPINAL NERVES. 

The nerves arising from the spinal column are arranged 
in pairs ; and each one has two roots, a posterior, or sensory 
and an anterior, or motor. The posterior is the larger, 
and has upon it a ganglion. The ganglion of the first 
cervical is frequently absent. After the roots unite, the 
nerves, having now both sensory and motor fibres, make 
their exit through the intervertebral foramina. Immedi- 
ately each one divides into a small posterior branch, and a 
large anterior branch. These branches must not be con- 
fused, by the student, with the anterior and posterior roots 
of spinal nerves, already described. The posterior branches 
supply the back of the trunk, the anterior ones the neck, 
the sides and front of the trunk and the extremities. 
There are thirty- one pairs of spinal nerves: — 

Cervical 8 pairs, 

Dorsal 12 " 

Lumbar 5 " 

Sacral 5 " 

Coccygeal 1 " 

Total 31 " 

There are eight cervical nerves, because the first one, sub- 
occipital, makes its exit above the first, and the last below 
the seventh cervical vertebra. The posterior branches of 
the spinal nerves are small and as a rule unimportant; the 
anterior in the upper and lower regions unite to form plex- 
uses, from which large and important trunks are given off. 
The plexuses are as follows : — 

Cervical, from anterior branches of four upper cervical, 
Brachial, " " u of four cervical and 1st 

dorsal. 
Lumbar, " " " of four upper lumbar. 

Sacral, M " " of four upper sacral and 

last lumbar (with part 
of 4th lumbar). 
These plexuses have communicating branches with the 
adjacent plexuses, so that inter-communication is established 
throughout. 

CERVICAL NERVES. 

The anterior branches of the first four cervical nerves 



SPINAL N.ERYES. 143 

unite to form the cervical plexus, while the last four with 
the first dorsal form the brachial plexus. 

CERVICAL PLEXUS. 

From anterior branches of 4 upper cervical nerves. 
Superficial branches. 1. Superficial cervical, to front 
and side of neck. 

2. Great auricular, to region of ear. 

3. Small occipital, to back of head 

and Occipito- frontal. 

4. Supra- clavicular, to front of 

chest and shoulder. 
Deep branches. . . 1. Communicans noni, to de- 
scending branch of hypo- 
glossal. 

2. Phrenic to diaphragm. Arises 

from 3d, 4th and 5th nerves, 
runs in front of Anterior sca- 
lene muscle, and alongside of 
pericardium. 

3. Muscular, to cervical muscles. 
The posterior branches of the cervical nerves have no 

important branches of distribution, except the second, which 
gives off the Great occipital, to supply the scalp. 

BRACHIAL PLEXUS. 

From anterior branches of four lower cervical and 1st 
dorsal. The 5th, 6th and 7th cervical unite, external to the 
Middle scalene, to form a large trunk ; the 8th cervical and 
1st dorsal join together behind the Anterior scalene to 
make another trunk. These trunks lie external to the 
subclavian artery ; and in the axilla just below the clavicle 
both of them bifurcate, thus making four branches. The 
two adjacent branches unite, forming a posterior cord, 
behind the axillary artery, while the two remaining branches 
are denominated the outer and inner cords, because of 
their relation to the vessel. We thus have three cords in 
the axilla, the outer, inner and posterior. These also bifur- 
cate, and would thus make six nerves, if it were not that 
the two adjacent branches of the outer and inner cords 
coalesce, over the artery, to form one. In this manner five 
important nerves are obtained for the upper extremity. 
Their names are as shown in the table : — 



144 COMPEND OF ANATOMY. 

5th C. ) f , f (l)External cutaneous, 

6th C. Upper trunk. . outei COra \ (2]Half of median, 
7th C. J > posterior f (3)Circumflex, 

^ £ l l 0W e r trU nk. cord } ^T^ "^-* 1 ' 

lst D " * inner cord { ? Half of median, 

L (5) Ulnar. 
There are many deviations from this arrangement, but, 
as it is the one usually given in the text-books and is easily 
understood, I have adopted it. The important branches 
from this large plexus must be carefully studied ; I have 
therefore endeavored to group them, at the same time 
omitting those that are of minor import. 

branches of brachial plexus. 

Thoracics. 

Posterior, or Long, from 5th and 6th cervical ; dis- 
tributed to Great serratus. 
Anterior, one from outer and one from inner cord ; 
to Pectorals. 
Supra- scapular, from 5th and 6th cervical ; to post- 
scapular muscles and shoulder joint. 
Sub-scapular, from posterior cord ; to Sub-scapular and 

posterior armpit muscles. . 
Cutaneous. 

Internal, from inner cord ; to inner side and front 

of arm and forearm. 
Lesser internal {of Wrisberg), from inner cord; to_ 

inner side of arm. 
External (or musculo- cutaneous), from outer cord ; 
to outside of forearm, Biceps, Anterior- and 
Coraco- brachial. 
Circumflex, from posterior cord ; to skin of shoulder, 

Deltoid and joint. 
Musculo- spiral, from posterior cord. 

. • • . 1 to extensors of fore- 

posterior interosseous, . , -, n 

* ' ! arm, wrist and fin- 

muscular, [ gers, and to supi- 

Branchea ^ J nators. 

radial, to integument of back of 3 J fingers.* 
cutaneous, to outside and back of arm and 
forearm. 

* Someauthorities state that the radial is distributed to 3 fingers, but the 
number given is preferable, bscause it corresponds with the palmar distri- 
bution. 



LUMBAR NERVES. 



145 



Median, from outer and inner cord, 
anterior interosseous, 



i 

Branches -< 



to pronators, to 

flexors,* and to 

muscular, first 2 Lumbri- 

J cals. 
cutaneous, to integument of radial half of 
palm and 3J fingers. 
Ulnar, from inner cord. 

" articular, to elbow and wrist, 
muscular, to muscles of little finger, all 
Interosseous, last two Lumbricals, and 
Branches \ Ulnar flexor of wrist. 

cutaneous, to integument of ulnar half of 
palm, and of dorsal and palmar surfaces 
of 1 J fingers. 

DORSAL NERVES. 

There are twelve pairs of dorsal nerves, which have their 
exit below the corresponding vertebrae and have posterior, or 
dorsal branches, supplying the skin and muscles of the 
back ; and anterior, or intercostal branches, distributed to 
the chest and abdomen. The intercostals do not unite in 
plexuses, but each one runs separately in the groove at the 
lower margin of the corresponding rib, and has muscular 
and cutaneous branches. The only branch requiring special 
notice is the lateral cutaneous branch of the second inter- 
costal, which is better known as the Inter costo-humeral. 
This large nerve pierces the chest wall, and crosses the 
axilla to join the lesser internal cutaneous (Wrisberg) of the 
arm. The first dorsal nerve is peculiar, because the greater 
portion of its fibres go to form the lower part of the brachial 
plexus. Its intercostal branch is, therefore, small. 

LUMBAR NERVES. 

The five pairs of lumbar nerves leave the spinal canal by 
the foramina under the corresponding vertebrae. The pos- 
terior branches supply the back ; while the anterior branches 
of the first four nerves coalesce to constitute the lumbar 
plexus. The anterior branch of the fifth and a communi- 
cating branch from the fourth form the lumbo sacral nerve, 
which is a constituent of the sacral plexus, as will be shown 
later. 

* The Deep flexor of fingers is supplied by both median and ulnar ; the 
Ulnar flexor of wrist by ulnar nerve. 
10 



146 



COMPEND OF ANATOMY. 



1st Lumbar, 



Lumbar 

Plexus. 



3d Lumbar, 

and 
4th Lumbar, 



LUMBAR PLEXUS. 

Formed from anterior branches of first four lumbar. 
The branches constituting this plexus are united by loops 
of communication, and the six nerves proceeding from it 
are : two from the 1st lumbar ; two from the 2d ; one from 
the 3d and one from the 4th lumbar, both of which bifur- 
cate and then form two nerves by union of their bifurca- 
tions. 

^Ilio-htpogastric, to gluteal re- 

J gion and abdomen. 

J Ilio-inguinal, to inguinal region 

and scrotum. 
C Genito- crural, to spermatic cord 
9 1 t i J and front of thigh. 

a - LjUmDar ? 1 External cutaneous, to outside 
of thigh. 
Obturator, through obturator 
canal to External obturator and 
Adductors and to knee joint. 
Accessory obturator, to Pec- 
tineus and hip joint (often 
absent). 
L Anterior crural, 

Middle cutaneous, to front of 

thigh. 
Internal cutaneous, to inside 

of thigh and leg. 
Long saphenous, to inside of~- 

leg and foot. 
Muscular, to muscles of front 

of thigh. 
Articular, to knee joint. 

SACRAL NERVES. 

The roots of the sacral and coccygeal nerves are long, like 
the lumbar, and form part of the cauda equina. There are 
five sacral ; and, therefore, the lower one must make its 
exit at the foramen between the sacrum and coccyx. 

sacral plexus. 

Formed from anterior branches of upper four sacral and 
5th lumbar, with a branch from 4th lumbar. The branch 
from the 4th lumbar unites with the 5th lumbar, forming the 
lumbo-sacral cord ? or nerve, which coalesces with the ante- 



COCCYGEAL NERVE. 147 

rior branches of the 1st, 2d, 3d, and 4th sacral nerves to 
thus complete the sacral plexus. The plexus lies upon the 
front of the Pyriformis muscle, and is triangular, with 
the apex towards the great sacro-sciatic notch, through 
which the greater portion escapes from the pelvis, below 
the Pyriformis. 
Branches of sacral plexus : — 

Muscular, to external rotators on buttock (viz: Internal 
obturator, Gemelli, Quadratus femoris and Pyri- 
formis. 
Superior Gluteal, to Middle and Smallest Gluteals. 
Pudic, re-enters pelvis by small sacro-sciatic foramen, to 

anus, perineum and genitals. 
Small Sciatic, to Great gluteal and back of thigh and 

leg. 
Great Sciatic, largest nerve ; lies midway between tuber- 
osity of ischium and great trochanter ; to flexors of 
leg. 
Internal Popliteal, to calf muscles, Popliteus, and 
knee joint. 

Posterior Tibial, to Posterior tibial muscle 
and Long flexors, 

internal plantar, to sole of 3 J toes, 

a few Lumbricals. 
external plantar, to sole of 1J toes, 
Interosseous, a fewLumbricals. 
Short Saphenous, to outside of foot and out- 
side of 5th toe. 
External Popliteal, or Peroneal, back and outside of 
leg, to knee joint. 

Communicating (communicans peronei), to 

join short saphenous. 
Musculo- cutaneous, to Peroneals, to top of 
toes, except adjacent sides of 1st and 2d. 
Anterior tibial, to Anterior tibial muscle, ex- 
tensors of all toes, and adjacent sides of 
1st and 2d toes. 

COCCYGEAL NERVE. 

There is only one coccygeal nerve. It has an anterior and 
a posterior branch, which are distributed about the coccyx. 
It is unimportant. 



148 COMPEND OF ANATOMY. 

SYMPATHETIC NERVOUS SYSTEM. 

The sympathetic system consists of a series of ganglia, 
situated on each side of the spinal column and in the skull, 
and connected together by communicating branches. From 
these ganglia are distributed branches to the most remote 
regions of the trunk and extremities. The sympathetic 
system is often called the nervous system of organic life, 
because its abundant distribution to the viscera seems to 
imply its intimate connection with the organic functions of 
growth and nutrition. 

These ganglia may be considered as distinct nervous 
centres, having branches of communication between them- 
selves, branches of connection with the cerebro- spinal 
nerves, and branches of distribution to the viscera, arteries 
and the cardiac and semilunar ganglionic masses. The 
sympathetic nerve has a tendency to form intricate plexuses 
about the arteries. The ganglia of the head, already de- 
scribed with the cranial nerves, lie between the cranial and 
facial bones. The cervical and dorsal ganglia are situated 
on each side of the vertebral bodies ; while the lumbar, sac- 
ral, and coccygeal lie in front of the corresponding bones. 
The single coccygeal ganglion (ganglion impar), situated in 
the middle line, joins the gangliated cords of the two sides 
together ; and it is believed by some that the cephalic ganglia 
are in a similar manner united above by a ganglion (of 
Eibes), located on the anterior communicating artery of the 
cerebrum. 

The number of ganglia on each side varies somewhat, be- 
cause they occasionally coalesce. The regions have usually 
the number assigned in the table below : — 

Cerebral portion, 1 in middle line, if it really exists, (gan- 
glion of Ribos). 
Cephalic portion, 4 on each side. 
Cervical " 3 " " 

Dorsal " 12 " u 

Lumbar " 4 " " 

Sacral " 5 " " 

Coccygeal " 1 in middle line. 

CEPHALIC GANGLIA. 

These have already been described, with the cranial nerves, 
on page 141. They are named the ophthalmic, the spheno- 
palatine, the otic, and the sub -maxillary. 



SYMPATHETIC NERVES. 149 

CERVICAL GANGLIA. 

There -are three in number on each side, and are called 
superior, middle and inferior. The superior, and largest, 
lies alongside of the third cervical vertebra and behind the 
carotid sheath ; the middle is small and sometimes absent, 
and lies opposite the fifth vertebra near the inferior thyroid 
artery 5 the inferior is located on a level with the seventh 
vertebra and near the superior intercostal artery- 

The important branches from these ganglia, in addition to 
the various communicating branches to the cerebro- spinal 
nerves, are : — 
From f carotid plexus. 

o v cavernous plexus. 

Superior ganglion j pharvngea f p i exus . 

I superior cardiac nerve. ") to cardiac 
Middle " middle cardiac nerve. [• ganglia & 

Inferior " inferior cardiac nerve. J plexuses. 

CARDIAC NERVES. 

There are three cardiac nerves on each side, derived, as 
shown above, one from each cervical ganglion. 

'right side, behind arch 
of aorta to deep car- 
diac plexus, 
left side, front of arch 
of aorta to superficial 
cardiac plexus. 

(2) Middle, or great, cardiac, nerve, both sides, behind sub- 

clavian to deep cardiac plexus. 

(3) Inferior, or small, cardiac, nerve, both sides, behind 

subclavian to deep cardiac plexus. 

The deep or great cardiac plexus is placed in front of the 
bifurcation of the trachea and behind the arch of the aorta. 
It is formed from all the cardiacs except the two mentioned 
below as forming the superficial plexus. Its branches form 
the posterior coronary plexus. 

The superficial cardiac plexus lies in front of the right 
pulmonary artery, and is formed by the left superior cardiac 
nerve and the inferior cardiac branches of the left pneumo- 
gastric. There is sometimes a small ganglion situated here, 
called the ganglion of Wrisberg. The branches of this 
plexus are distributed to the right coronary artery, forming 
the anterior coronary plexus. 



(1) Superior, 

or superficial, cardiac nerve, 



150 COMPEXD OF ANATOMY. 

DORSAL OR THORACIC GANGLIA. 

The twelve thoracic ganglia of each side are placed be- 
hind the pleura against the heads of the ribs. The im- 
portant branches of the first six ganglia are small, and 
supply the aorta and form the posterior pulmonary plexuses. 
The anterior pulmonary plexuses are formed from the deep 
cardiac plexus. The six lower ganglia have large branches, 
which unite to form three important nerves ; the great, 
the lesser, and the smallest or renal, splanchnic nerves. 
Great Splanchnic, from 6th-9th ganglia (connecting with 
upper six) ; through crus of diaphragm, to semi- 
lunar ganglion and solar plexus. 
Lesser Splanchnic, from lOth-llth ganglia; through crus 
of diaphragm, to semilunar ganglion and solar 
plexus. 
Smallest Splanchnic, from 12th ganglion ; through crus of 
diaphragm, to renal plexus. 
The Solar Plexus and Semilunar Ganglia. 
The solar plexus, or "belly brain," consists of ganglia 
and a network of nerve branches, lying behind the stomach, 
in front of the aorta, and surrounding the cceiiac axis and 
superior mesenteric artery. It receives the greater and 
lesser splanchnics of both sides, and the right pneumo- 
gastric nerve. Alongside of the plexus proper are found 
two semilunar, or crescentic, ganglionic masses, formed of 
small ganglia. Each semi-lunar ganglion lies near the 
supra-renal capsule, and alongside of the cceiiac axis and 
superior mesenteric artery. Between the semi-lunar ganglia 
the network of the solar plexus is found. 

The solar plexus is single, and from its branches are 
formed plexuses accompanying the arteries of the abdomen. 
They correspond closely, therefore, with the branches of the 
aorta, and in certain places have additional ganglia. AVhen 
the arteries occur in pairs, the plexuses do the same ; when 
the arteries are single, but one plexus is required. 

The plexuses derived from the solar plexus and semi- 
lunar ganglia are : — 

Phrenic, Supra renal, 

Cceiiac, Renal, 

Gastric, Superior Mesenteric, 

Hepatic, Spermatic or Ovarian, 

Splenic, Inferior Mesenteric, 

Aortic (partly also from lumbar ganglia). 



SYMPATHETIC NERVES. 151 

Plexuses are distributed to the branches of these arteries 
in a similar manner ; as, indeed, are sympathetic filaments 
to the arteries throughout all the extremities. 

LUMBAR GANGLIA. 

The four lumbar ganglia lie in front of the vertebral 
bodies, at the inner margin of the Great psoas. The 
branches aid in forming the aortic and hypogastric plexuses. 

SACRAL AND COCCYGEAL, OR PELVIC GANGLIA. 

The five sacral, on each side, and the single coccygeal 
ganglion (ganglion impar), lie in front of the sacrum and 
coccyx. The branches from the lumbar and those from the 
first two sacral ganglia form the single hypogastric plexus, 
lying in front of the sacral promontory. This divides below, 
and, with the branches from the remaining ganglia, makes 
the two inferior hypogastric, or pelvic, plexuses. From 
these are distributed branches forming plexuses for the 
bladder, vagina, uterus, rectum (hemorrhoidal), prostate and 
other pelvic viscera. 



152 COMPEND OF ANATOMY. 



CHAPTER VI. 



ORGANS OF DIGESTION. 

Under the term digestive apparatus are included the 
mouth, pharynx, oesophagus, stomach, large and small in- 
testines, and certain accessory organs, which have functions 
necessary to the completion of the digestive process. The 
accessory organs located within, or in the vicinity of, the 
mouth are the teeth, tongue and salivary glands ; those sit- 
uated in the abdomen are the* liver and pancreas. The 
spleen, although not an organ of digestion, is usually de- 
scribed with the other abdominal organs. 

THE MOUTH. 

The mouth is an oval cavity, in which the food is masti- 
cated, or chewed, preparatory to deglutition, and which also 
serves as an entrance to the respiratory tract. It is bounded 
by lips, cheeks, jaws, palate and tongue, and opens posteri- 
orly into the pharynx. The lining mucous membrane is 
continuous with that of the pharynx and oesophagus. 

The Teeth are imbedded in the alveolar processes of the 
jaws and are surrounded by the gums, which are composed 
of fibrous tissue covered with mucous membrane of slight" 
sensibility. There are two sets of teeth: the temporary, or 
milk, teeth of childhood ; and the permanent, which appear 
after the shedding of the milk teeth and last during the 
greater part of adult life. The temporary teeth are ten, the 
permanent sixteen in number in each jaw ; which makes in 
both jaws twenty temporary and thirty-two permanent teeth. 
The teeth of each half of each jaw are : — 

f incisors, two. P^f'on™ 

Temporary] canine, one. Permanent -j ^^"two. 
I molars, two. [ molars, three. 

All teeth have a crown, or body, which is the portion seen 
above the gum ; a root, or fc:ng, inserted into the socket in 
the jaw ; a neck, or constriction, between the crown and the 
fang. A vertical section of a tooth shows a cavity in the 
interior, called the pulp cavity, which is continuous with an 
orifice in the point of the root. Vessels and nerves enter 



MOUTH. 153 

the pulp cavity by this small aperture. The main portion 
of the tooth consists of dentine, which is composed of tubes, 
lying in the inter-tubular tissue. The tubules open into 
the pulp cavity and contain prolongations of the pulp 
tissue, called dentinal fibres. The dentine forming the 
crown is covered by a layer of very hard and compact tissue, 
called enamel ; while the fang is in a similar way covered 
by a layer of bone-like material, called the cement or crusta 
petrosa. 

The Temporary Teeth are smaller than the permanent, 
but similar in structure. There are five in each half of each 
jaw, namely: two incisors, one canine, two molars. The 
molars occupy the positions subsequently filled by the bicus- 
pids of the permanent set. 

Permanent Teeth. — The incisors have a sharp cutting 
edge, and are situated in the front of the mouth. They 
number four in each jaw. The canine are placed one on 
each side of the incisors, thus making two in each jaw ; and 
have a conical pointed crown adapted to tearing food. The 
upper canines are popularly known as eye teeth, the lower 
as stomach teeth. There are two bicuspids situated behind 
each canine. They have two eminences, or cusps, on the 
grinding surface of the crown, and the roots, though single, 
like those of the teeth already described, show a tendency 
to bifurcation at the extremities, and are grooved by a line, 
as though the separation into two roots had not been com- 
pleted. The molars, the largest teeth, are the most pos- 
terior, and number three on each side of each jaw. They 
have large crowns, divided into four or five cusps, or points, 
and are the grinding teeth. The root consists of from two 
to five long processes, each of which has an opening for the 
entrance of vessels and nerves. The most posterior molars 
are called wisdom teeth. 

The eruption of the temporary teeth begins at the age of 
seven months, and is finished when the child is two or two 
and a half years old. The teeth in the lower jaw usually 
show themselves before the corresponding ones of the upper 
jaw. The permanent teeth make their appearance between 
the sixth and twenty-first year ; and those of the lower jaw 
usually manifest themselves before their antagonists of the 
upper ja^y. 

The time of eruption of the two sets is approximately as 
follows: — 



154 COMPEND OF ANATOMY. 



Temporary, 




central incisors, 


7 months. 


lateral incisors, 


7 to 10 months 


anterior molars, 


12 to 14 months 


canines, 


14 to 20 months 


posterior molars, 


18 to 36 months 


Permanent, 




first molars, 


6J years. 


central incisors, 


7 years. 


lateral incisors, 


8 years. 


first bicuspids, 


9 years. 


second bicuspids, 


10 years. 


canines, 


11 to 12 years. 


second molars, 


12 to 13 years. 


third molars, 


17 to 21 years. 


THE 


PALATE. 



■ The hard palate, consisting of the palate processes of the 
superior maxillary and palate bones, and covered with 
mucous membrane, forms the roof of the mouth and the floor 
of the nose. The soft palate, formed of muscles and fascia 
covered by mucous membrane, hangs from the posterior 
edge of the hard palate. At the middle of its free border is 
a pendulous process, called the uvula ; on each side of which 
are seen two crescentic folds, or arches, of mucous metf 7- 
brane, stretching over to cover the Palato-glossus and 
Palato-pharyngeus muscles. These folds and projecting 
muscles form the anterior and posterior pillars of the palate, 
sometimes called pillars of the fauces. Between them on 
each side lies the tonsil gland, presenting a dozen small 
follicles. 

SALIVARY GLANDS. 

These glands, situated about the mouth, furnish saliva in 
large quantity during the process of mastication ; and a 
certain amount of fluid is secreted during the intervals 
between the times^of taking food. Their structure is con- 
glomerate ; that is, they consist of many small lobules united 
together to form larger lobes. The three salivary glands 
are named, parotid, submaxillary, and sublingual. 

The parotid lies in front of and below the ear, extending 
from the zygoma down to the level of the angle of the lower 
jaw. The external carotid artery, as it ascends, is sur- 
rounded by it, and the facial nerve passes through it trans- 



ABDOMEN. 155 

versely. Just below the zygoma and lying on the Masseter 
muscle is seen a detached lobe of the gland, called socia 
parotidis (associate of the parotid). The duct of the parotid, 
called Steno : s duct, is two and a half inches long, and opens 
into the mouth upon the inside of the cheek, opposite the 
second molar tooth of the upper jaw. It corresponds, in 
direction, with a line drawn from the base of the lobule of 
the ear to the middle of the upper lip. The submaxillary 
gland lies under the lower border of the lower jaw, in the 
submaxillary triangle, and is separated from the parotid by 
the stylo-maxillary ligament, and from the sublingual by the 
Mylo-hyoid muscle. The facial artery is imbedded in it. The 
duct, named after Wharton, opens alongside of the frenum 
of the tongue. 

Under the mucous membrane of the floor of the mouth, 
close to the inside of the symphysis of the jaw, is found the 
smallest of the salivary glands, the sublingual. It has ten 
to twenty small ducts, called the ducts of Rivini; some of 
which open separately alongside of the frenum, while others 
join together, forming the duct of Bartholine, which con- 
nects with the duct of the sub-maxiilary gland. 

PHARYNX AND CESOPHAGUS. 

The pharynx is a dilatation of the upper part of the oeso- 
phagus, and extends from the basilar process of the occi- 
pital bone to the level of the cricoid cartilage and fifth 
cervical vertebra. It has opening into it the two posterior 
nostrils, the two Eustachian tubes, the mouth, the larynx 
and the oesophagus. 

The oesophagus is the continuation of the pharynx, and 
is a tube, about nine inches in length, extending to the car- 
diac end of the stomach. It is situated in the posterior 
mediastinum, in front of the vertebral column, and behind 
the trachea and great vessels. There is an opening in the 
diaphragm for its passage to the stomach. The oesophagus 
has an external coat, composed of circular and longitudinal 
muscular fibres, a middle coat of cellular tissue, and an in- 
ternal mucous coat. 

ABDOMEN. 

As the digestive organs are to a great extent contained in 
the abdominal cavity, it becomes necessary to describe this 
portion of the trunk, before proceeding to the details of the 
proper and accessory organs of digestion. The abdomen is 
a large cavity extending from the diaphragm above to the 



156 COMPEND OF ANATOMY. 

brim of the pelvis below, and bounded in front and at the 
sides by ribs, muscles and the iliac bones, and behind by 
the vertebral column, the ribs and muscles. There are 
several openings in the walls of the abdomen ; in the ante- 
rior wall, the umbilicus for the passage, during foetal life, 
of the umbilical vessels, the tvo openings for the femoral 
vessels, and the two inguinal canals for the spermatic cords 
or round ligaments ; in the superior wall (diaphragm), are 
the apertures for the aorta, vena cava and oesophagus. 

The abdomen is divided into nine regions by four imagi- 
nary lines, drawn over its anterior surface. The two hori- 
zontal lines are drawn across at the level of the ninth costal 
cartilages and at the top of the iliac crests ; the two vertical 
lines from the cartilages of the eighth ribs to the middle 
of Poupart's ligaments. The three median spaces, thus 
mapped out, are named from above downwards ; epigastric, 
umbilical and hypogastric regions. The lateral spaces are 
denominated right and left hypochondriac, lumbar, and in- 
guinal regions. The inner surface of the abdominal Avails 
is covered entirely, and the organs to a great extent, by a 
serous membrane, called peritoneum. 

PERITONEUM. 

This is a serous sac, with no opening in the male ; but 
with openings in the female, at the ends of the Fallopian 
tubes, where the mucous membrane, lining these, is con^ 
tinuous with the peritoneum. The portion of peritoneum 
covering the wall of the abdomen is called the parietal, that 
investing the viscera, the visceral, peritoneum. The peri- 
toneum completely covers a number of the viscera, and, 
where it leaves their surfaces, forms ligaments consisting 
of two layers by which they are attached to the abdominal 
wall, or to adjacent organs. A few of the viscera lie behind 
the peritoneum covering the back wall of the abdomen, and 
are therefore called post-peritoneal organs. 

The reflections of the peritoneum, as seen in an antero- 
posterior section of the body, may be described as follows: 
Taking for a beginning two points, one at the back and the 
other at the front of the diaphragm, we find that the peri- 
toneum covers the lower surface of this muscle ; opposite 
the back of the liver the layer from the front joins the layer 
from the back, and they pass to the surface of the liver, 
forming its coronary ligament. The two layers then sepa- 
rate to envelope the liver, and, when opposite the lesser 



ABDOMEN. 157 

curvature of the stomach, unite and pass over to it, consti- 
tuting the gastro-hepatic ligament (or omentum). The 
stomach is then invested, after a separation of the layers, 
and fiom its greater curvature the two layers, again united, 
pass downward for about six inches. They then make a 
sharp bend and curve upwards, until they meet the trans- 
verse colon, where they divide and encircle this portion of 
the great intestine. From the transverse colon the two 
layers, again united, pass back to the spinal column, to 
attach the colon to the posterior abdominal wall, thus 
forming a ligament called the meso- colon. From this 
point we are obliged to consider each layer separately. 
The upper layer of the meso-colon, which has all along 
been the posterior layer, passes up the posterior wall to its 
starting point at the back of the diaphragm. The lower 
layer of the meso-colon, which has been the anterior layer 
all the time, descends a'ong the vertebral wall until oppo- 
site the small intestines ; here it is carried across to the 
small bowels, and, having invested them with a complete 
covering, returns to the vertebral wall, thus forming a 
ligament to hold them in position, called the mesentery. 
After forming in this manner the mesentery, it descends 
along the front cf the spine into the pelvis, surrounds the 
upper part of the rectum (forming the meso-rectum), and 
then passes to the top of the bladder and up the anterior 
belly-wall to the starting point at the front of the Dia- 
phragm. In the female it extends from the rectum to the 
top of the vagina and uterus, before reaching the bladder. 

The Great Omentum. — The portion of peritoneum hang- 
ing down from the stomach and bending upwards to the 
colon is called the gastro-colic ligament or omentum, or 
more frequently the great omentum. It consists of four 
layers with a cavity, between the second and third layers, 
which is a part of the cavity enclosed by the posterior layer 
of peritoneum, which we traced from the back of the dia- 
phragm. This cavity is named the lesser peritoneal cavity, 
or cavity of the great omentum. The large space formed 
by the reflections of the anterior layer, which started from 
the front of the diaphragm, is denominated the greater 
peritoneal cavity. The lesser and greater peritoneal cavi- 
ties communicate with each other by the foramen of Win- 
slow, which is an opening large enough to admit the finger, 
located behind the right border of the gastro-hepatic 
or lesser omentum. The left border of this omentum is 



158 COMPEND OF ANATOMY. 

not free, but attached to the lower extremity of the oesopha- 
gus between the Diaphragm and stomach. 

This description of the manner in which the peritoneum, 
as seen in an antero-posterior section, invests the viscera, 
would be incomplete if it were not stated that the membrane 
passes laterally from the organs to the sides of the abdomen 
and from one organ to another. Thus are formed lateral 
ligaments for the liver, and where it passes upwards from 
the liver there is made a suspensory ligament. It passes 
likewise from the stomach to the spleen, forming the gastro- 
splenic ligament or omentum ; from the spleen to the dia- 
phragm, making a suspensory ligament ; and from the spinal 
column laterally, covering the front of duodenum, and the 
ascending and descending colon. The kidneys, suprarenal 
capsules and pancreas are situated behind the peritoneum, 
between it and the spinal column and ribs. 

The Foramen of Winslow. — There would be left a large 
communicating space, between the lesser and greater peri- 
toneal cavities, at the right edge of the gastro-hepatic omen- 
tum, if it were not that the gastric and hepatic arteries 
(which, coming from the coeliac axis, lie behind the perito- 
neum) pushed the peritoneum in front of them, as it were, 
in their passage to the stomach and liver. This, causing a 
diminution of the opening of communication, gives the ap- 
pearance of a narrow canal or foramen connecting the two 
peritoneal cavities. Nothing passes through this foramen^__ 
of Winslow, and it is really only a constriction, or narrow- 
ing, of the general peritoneal sac or cavity, which is thus 
made to appear like two cavities connected by a neck-like 
orifice. This may be illustrated, in a familiar way, by tak- 
ing a large bag, with the mouth sewed shut, and tying a cord 
loosely around it near one extremity. The larger portion 
of the bag represents the greater peritoneal cavity ; the 
smaller, the lesser cavity of the peritoneum ; the constricted 
orifice between them, the foramen of Winslow ; and the 
cord, the gastric and hepatic arteries curving around the 
general sac in such a manner that a constriction of the cavity 
within is produced. 

STOMACH. 

The stomach is a dilatation of the intestinal tract, which 
has for its function the chymification of the food introduced 
through the mouth and oesophagus. It is a pouch, lying 
under the diaphragm, in the epigastric and left hypochon- 



INTESTINES. 159 

driac regions, and has a greater curvature, a lesser cur- 
vature, a cardiac or oesophageal extremity, and a pyloric 
or intestinal end. It is about ten inches in length and 
about five in vertical diameter at its widest part. The 
walls are composed of four coats, a serous or peritoneal, 
which is external, a muscular, a sub-mucous, and an inter- 
nal or mucous. The muscular coat consists of fibres running 
in three directions, hence called longitudinal, circular and 
oblique fibres. The longitudinal are continuous with the 
longitudinal fibres of the oesophagus, the circular run around 
the organ, while the oblique are found in the vicinity of 
the cardiac orifice. The mucous membrane presents under 
the microscope a honeycomb appearance, due to the many- 
sided alveoli or depressions found in it. In the bottom of 
these depressions are seen the openings of the glands of 
the stomach ; of which those near the pyloric end are sup- 
posed to secrete the gastric mucus, the remainder the acid 
gastric juice for digestion. 

SMALL INTESTINE. 

The small intestine is about twenty feet long, and is divided 
into the duodenum, jejunum and ileum. 

Duodenum. — The duodenum is ten inches long and con- 
sists of the ascending, descending and transverse portions. 
It is the first part of the intestine, and has lying within its 
curvature the right extremity or head of the pancreas. It 
is only partially invested with peritoneum, and has opening 
into its descending portion the common bile duct and the 
pancreatic duct. 

Jejunum. — The jejunum is two-fifths of the remainder of 
the small intestine, and extends from the duodenum, which 
ends at the left side of the second lumbar vertebra, to the 
ileum. There is no exact point marking the termination of 
the jejunum and the beginning of the ileum. 

Ileum. — This is the name given to the remaining three- 
fifths of the small bowel, which extends to the commence- 
ment of the large intestine. Observe the different spelling 
of ileum, the bowel, and ilium, the bone. 

The small intestine has, like the stomach, four coats, 
serous, muscular, cellular or sub-mucous, and mucous. 
The muscular coat has external or longitudinal fibres and 
internal or circular fibres. The mucous membrane pre- 
sents upon its surface columnar epithelium ; valvulae conni- 
ventes or transverse ridges, formed by reduplications of the 



160 



COMPEND OF ANATOMY. 



mucous and sub-mucous coats, whose purpose seems to be 
to retard the intestinal contents and give more absorbing 
surface ; and the villi, which are minute projections, con- 
taining blood-vessels and lacteals, covering the mucous 
membrane. 

The glands of the small intestine are the simple folli- 
cles (of Lieberkiihn) found throughout the small intestine ; 
the duodenal, or Brunner's glands, resembling in structure 
the pancreas, and found only in the duodenum and upper 
part of jejunum ; the solitary glands found throughout the 
small bowel, though they are more numerous in its lower 
part, and which are now looked upon as belonging to the 
lymphatic system; and finally Peyer's glands or patches. 
The glands of Peyer are to be regarded as composed of 
numerous solitary glands, collected together in patches. 
There are about two dozen such patches found throughout 
the small intestine ; but they are larger and more numerous 
in the lower part of the ileum than elsewhere, although 
they have been seen even in the duodenum. They may be 
circular or oval ; when oval the long diameter corresponds 
with the length of the intestinal tube. Large ones may be 
four inches long. - 

The characteristics of the parts of the small bowel may be 
stated as follows : — 



DUODENUM. 

Largest in diameter. 
Thickest coats. 
Valvulae conniventes. 
Brunner's glands. 
No mesentery. 



More vascular 
than ileum. 
Valvulae conni- 
ventes marked. 
Villi marked. 
Few Peyer's 
patches. 

LARGE INTESTINE. 



ILEUM. 

Less vascular than 
jejunum. 

Valvulae conniven- 
tes almost absent. 

Villi small. 

Many and large 
Peyer's patches. 



The large intestine is five feet long, extends from the 
ileum to the anus, and is characterized by its large calibre, 
sacculated appearance and comparative immobility. It 
begins in the right inguinal region, ascends to the liver, 
crosses the abdomen, descends on the left side, and then 
enters the pelvis to descend along the front of the sacrum 
to the anus. Its subdivisions are caecum, colon, rectum; 
and the colon is further divided into the ascending, trans-, 
verse and descending portions, and the sigmoid flexure. - 



INTESTINES. 161 

Cecum. — This blind pouch forms the beginning of the 
large intestine, and shows at its junction with the ascending 
colon the entrance of the ileum. At this orifice is situated 
the ileo-caecal va.ve, consisting of two leaflets. They are 
formed by reduplications of the mucous membrane and by 
circular muscular fibres, over which the longitudinal fibres 
pass continuously. The surfaces of the valve differ, because 
the side towards the ileum has its characteristic mucous 
membrane, and that towards the caecum the peculiarities of 
the membrane lining the great intestine. From the lower 
and posterior part of the caecum hangs the vermiform ap- 
pendix, which is a long, worm-like tube, that is an analogue 
of the lengthened caecum found in many animals. 

Colon. — The ascending colon extends from the caecum to 
the lower surface of the liver, where it bends to the left to 
become the transverse portion of the co^n. The transverse 
extends from this hepatic flexure to the splenic flexure on 
the left side ; here the great intestine passes downwards to 
the left inguinal region, where it makes a number of turns 
and becomes narrower. This portion is named the sigmoid 
flexure, and extends to the beginning of the rectum. The 
transverse colon has the great omentum attached to it. 

Rectum. — This portion of the bowel is about eight inches 
in length, and is not sacculated. It begins at the left sacro- 
iliac joint, and, reaching the middle line of the sacrum, de- 
scends to the anus after making a bend backwards around 
the point of the coccyx. It is distended just above the anus 
to form a sort of pouch. The transverse colon is the only 
portion of the great bowel that is almost completely invested 
by peritoneum, which here, as previously stated, forms the 
transverse meso colon. The other portions are, as a rule, 
only covered by the peritoneum in front and perhaps late- 
rally ; though in some instances there is more or less meso- 
colon for these parts of the bowel. The lower part of the 
rectum has no peritoneum whatever. 

The large intestine has a serous, a muscular, a cellular 
or sub-mucous, and a mucous coat. Along the colon and 
part of the rectum there are attached numerous small 
pouches of peritoneum, containing fat ; these are the omen- 
tum-like appendixes (appendices epiploicae). The saccu- 
lated appearance of the colon is due to the longitudinal 
fibres of the muscular coat being collected into three 
narrow bands, which are shorter than the gut, and hence 
cause it to become pouched. These bands are readily 



162 COMPEND OF ANATOMY. 

seen. The mucous membrane of the great intestine is 
smooth and without villi. It presents columnar epithelium, 
simple follicles and solitary glands. The latter are more 
abundant at the beginning of the large intestine than else- 
where in its extent. 

liter. 

The liver is a large gland, secreting bile and causing certain 
changes to take place in the blood. It is located mainly in 
the right hypochondriac and the epigastric regions. It weighs 
three pounds, and has the following dimensions: thickness, 
3 inches ; antero-posterior diameter, 6 inches ; transverse 
measurement, 12 inches. The gland is convex on its upper 
surface, concave on its lower ; has a rounded posterior and 
a sharp anterior border. It has five ligaments, five fissures, 
five lobes, and five sets of vessels. 

Ligaments, 

Suspensory, falciform, or broad ; above. 

Two lateral ; one at each side. 

Coronary ; behind. 

Round ; which is the obliterated umbilical vein. 

Fissures {all on under surface). 

Longitudinal ; in which the round4igarftent lies. 

Fissure of ductus venosus; being posterior half of longi- 
tudinal. 

Transverse ; where vessels enter liver. 

Fissure for the gall bladder. 

Fissure for vena cava. 

Lobes, 

Right. 

Left. 

Square (lobus quadratus) ; between longitudinal fissure 
and fissure for gall bladder. 

Lobe of Spigelius ; between fissures for ductus venosus 
and vena cava. 

Caudate lob 3 ; joining lobe of Spigelius and right lobe. 

Vessels, 

1. Portal vein, ] 

2. Hepatic duct, I in trangverge figsure _ 

3. Hepatic artery, 

4. Lymphatics, J 

6. Hepatic veins ; seen at back, opening into vena cava. 



LIVER AND PAXCREAS. 163 

Structure. — The liver is made up of lobules, which are 
small granular bodies about one-tenth of an inch in diame- 
ter, and grouped about the small branches of the hepatic 
veins. Every lobule consists of liver cells, capillary bile 
ducts, capillaries of the portal vein, of the hepatic veins, 
and of the hepatic artery, and probably contains in addition 
nerves and lymphatics. As previously described, the portal 
vein brings blood to the liver, from which bile is formed; 
the hepatic, or bile, duct carries the bile towards the gall 
bladder and duodenum ; the hepatic artery furnishes arterial 
blood for the nutrition of the various parts of the organ; 
and the hepatic veins return the venous blood, no longer 
needed, to the vena cava. The small branches of the portal 
vein run between the lobules, and are denominated inter- 
lobular veins; smaller branches from these enter the lobules 
and form intra lobular veins. These empty into a larger 
vein, around which the lobules are grouped, called the sub- 
lobular vein. From these sub-lobular veins the hepatic 
veins are formed. The vessels, as they enter the liver by 
the transverse fissure, are covered by areolar tissue, which 
follows them in their ramifications through the liver struc- 
ture. This is the capsule of Glisson. It is probable that 
the capillaries of the bile duct, portal vein, hepatic vein 
and hepatic artery inter-communicate in the interior of the 
organ. 

Gall Bladder. — This reservoir for the bile lies under the 
anterior edge of the right lobe of the organ. It holds about 
eight fluid drachms, and has a duct, the cystic, which joins 
the hepatic duct about an inch and a h^f below the exit of 
the latter from the liver. The junction of these two ducts 
forms the common bile duct (ductus communis choledochus), 
which empties into the descending duodenum, near the 
entrance of the pancreatic duct. It will be seen that the 
gall bladder is a receptacle for storing bile, until it is re- 
quired during the digestive process. It is filled by the' bile 
passing up the cystic from the hepatic duct ; when required, 
the fluid passes down the cystic and onward in the common 
duct to the intestine. 

pancreas. 

This gland resembles the salivary glands, in being con- 
glomerate ; that is, made up of small lobule3 whose ducts 
unite with those of other lobules to form larger lobules, 
or lobes. It is six inches long, is located across the spinal 



164 COMPEXD OF ANATOMY. 

column, behind the stomach, and has a tail toward the 
spleen and a head lying in the concavity of the duodenum. 
Its duct runs transversely and opens into the descending pait 
of the duodenum. 



The spleen is a ductless organ or gland, having some func- 
tion in connection with the blood corpuscles, of which we 
know comparatively little. It lies to the left of the cardiac 
end of the stomach, to which it is attached by the gastro- 
splenic omentum. It has a suspensory ligament, consisting 
of peritoneum, holding it to the diaphragm. The proper 
spleen substance is enclosed in a network of tissue like con- 
nective tissue, and is reddish-brown in color. A section of 
the spleen reveals, connected with the arterial capillaries, 
numerous semi-opaque, whitieh bodies, called corpuscles of 
Malpighi. . These are capsules, or sacs, containing a semi- 
fluid substance, and are said to be large when the animal 
has. been well fed. They are believed to be a portion of the 
lymphatic system. 



ORGANS OF CIRCULATION AND RESPIRATION. 165 



CHAPTER VII. 



ORGANS OF CIRCULATION AND RESPIRATION. 

THE THORAX. 

The thorax is the upper portion of the trunk, and is formed 
by the dorsal vertebrae, ribs, costal cartilages and sternum. 
It is separated from the abdomen below by the diaphragm;, 
and contains, among other structures, the heart, pericardium, 
lungs, pleura, great vessels, trachea, and oesophagus. 

CIRCULATORY ORGANS. 

PERICARDIUM. 

This membranous sac has two layers ; the external or 
parietal, which is fibro- serous, and forms a conical bag with 
its base on the diaphragm and its apex about the great ves- 
sels ; and the internal, or visceral, which is serous, and 
closely invests the heart and the root of the great vessels 
for two inches. Between these layers is the cavity of the 
pericardium, usually containing a small amount of serous 
fluid. 

HEART. 

The central organ of circulation, called the heart, is a 
hollow muscle of conical shape, placed in the thorax with 
its base upwards, backwards, and to the right, and its apex 
pointing downwards, forwards and to the left. It extends 
from the upper edge of the third costal cartilages to the 
level of the sixth cartilage ; and has its apex behind the fifth 
intercostal space, about one inch within, and two inches 
below the left nipple. Its weight is a little over half a 
pound. Its interior is lined by a serous membrane, the en- 
docardium, as its exterior is covered by the visceral peri- 
cardium. It is divisible into a right or venous, and a left 
or arterial, side. Each side consists of two cavities, an 
auricle and a ventricle. The superior cavities are the 
auricles and have much thinner walls than the ventricles. 
The venous blood, from the venae cavae and the proper veins 



166 COMPEND OF ANATOMY. 

of the heart walls, is poured first into the right auricle ; 
then, passing through the right auriculo- ventricular open- 
ing, it enters the right ventricle. Fiom here it goes to the 
lungs by the pulmonary artery ; after receiving oxygen, it is 
conveyed to the left auricle by the pulmonary veins, and 
then passes into the left ventricle, and finally into the 
aorta. 

The right auricle has connected with its cavity the 
auricular appendix, a small sac overlying the root of the 
pulmonary artery. The openings into the right auricle 
are : the superior vena cava and inferior vena cava, with 
the unimportant and scarcely visible tubercle of Lower 
between them ; the coronary sinus and veins of Thebesius, 
bringing venous blood from the walls of the heart ; and the 
opening into the ventricle, guarded by the tricuspid valve. 
The other points to be noticed are : the Eustachian valve, 
below the opening of the inferior vena cava ; the coronary 
valve, at the entrance of the coronary sinus ; the oval fossa, 
surroundeoTby~the^oval ring (annulus ovalis), on the septum 
between the two auricles ; and the muscular bands on the 
inside of the auricular appendix, which are called pectinate 
muscles. The oval fossa is the remains of the oval foramen, 
which in foetal life allows blood to pass from the right into 
the left auricle. 

The right ventricle. — This cavity has a triangular form, 
and is continued upwards as a funnel-shaped prolongation 
leading to the opening into the pulmonary artery. The 
internal surface of its wall is irregular, on account of the 
fleshy columns (columnae carnese) projec'ing from it. The 
openings into the right ventricle are the auriculo- ventricular 
and the pulmonary artery. The first is guarded by the 
tricuspid valve, consisting of three leaflets made by redupli- 
cations of the endocardium, and which prevents regurgita- 
tion of the blood into the auricle during the contraction of 
the ventricle. There is allowed at this valve, however, a 
slight amount of regurgitation, in order to protect the lungs 
from undue engorgement. The free edges of the leaflets are 
attached to tendinous cords (chordae tendineae), which come 
from the papillary muscles, and prevent the valve being forced 
upwards into the auricle by the blood current thrust against 
the closed valve, when the ventricle contracts. The pulmo- 
nary orifice is provided with the semilunar valves, which are 
three crescentic folds that prevent the blood flowing from 
the artery back into the ventricle. On the free border of 



HEART. 1G7 

each is a nodule (bodies of Arantius), and behind each 
leaflet is seen a little pouch or pocket called a sinus (sinuses 
of Valsalva). 

The left auricle is similar to the auricle of the other 
side, as far as shape is concerned, but it has fewer points for 
examination. Four pulmonary veins open into it and dis- 
charge the arterial blood just oxygenated by the lungs. On 
the wall, between it and the right auricle, is seen a depres- 
sion corresponding with the oval fossa, described previously 
when discussing the right side of the heart. The opening 
into the ventricle is provided with a valve of two leaflets, 
called the bicuspid, or mitral, vJ.ve. 

The left textricle resembles the right, but has walls 
three times as thick. It extends downward and projects 
beyond the right, so as to form the apex or point of the 
heart. The mitral valve has only two leaflets, but is similar 
to the tricuspid in attachment a id-action. The fleshy columns 
and the tendinous cords of this cavity are the same as oa the 
other side of the heart. The aortic opening, like the pul- 
monary, has three senil-liinar valves, with bodies of Arantius 
and sinuses of Valsalva- 

Structure of the Heart. — The heart is composed of 
muscular fibres of the striped variety, although it is emin- 
ently an involuntary muscle. It -ha-5 a fibrous skeleton, as 
we may call it, consisting c-f tour strong fibrous rings sur- 
rounding the auriculo- ventricular and arterial openings ; to 
these are attached the twisted and interlaced fibres which 
make up its walls. This fibrous framework in some animals 
is partly composed of actual bone. 

Position of the Valves. — The actual situation of the 
valves, in reference to external landmarks, has been deter- 
mined by thrusting needles into the thorax. 

The mitral valve lies at the left edge of the sternum in 
third intercostal space. 

The tricuspid valve lies a little under the sternum, a few 
lines below. 

The pulmonary valve lies at the left edge of the sternum 
at junction with third cartilage. 

The aortic valve lie 3 quite near pulmonary, but a little 
lower. 

These are the anatomical positions of the valves, and, as 
is seen, they all lie so near together that the area can be 
covered by a silver dollar ; hence^ in auscultation, as the 



168 C0MPEND OF AX ATOMY. 

sounds of the valves are to be differentiated, it is necessary 
to select points more remote from each other. 

The clinical location of the valves is, therefore, as fol- 
lows : — 

The mitral valve is to be listened for near the apex beat. 

The tricuspid valve is to be listened for near the base of 
ensiform cartilage. 

The pulmonary valve is to be listened for near the left edge 
of sternum, in second interspace. 

The aortic valve is to "be listened for near right edge of 
sternum, in second interspace. 

FCETAL CIRCULATION. 

The peculiarities of the fcetal heart, which are of import- 
ance, to remember, are: first, the communication between 
the two auricles by means of the oval foramen in the sep- 
tum ; secondly, the large Eustachian valve, which directs 
the blood, entering the right auricle from the ascending vena 
cava, across the auricle and through the oval foramen into 
the left auricle. The arteries ofthefcetus alsohave two"oecu- 
liarities: first, there is a ccmmunication between the left 
pulmonary artery and the arch of the aorta by a short ves- 
sel called the arterial duct (ductus arteriosus); and secondly, 
the internal iliac arteries are connected with the mother's 
placenta by the hypogastric and umbilical arteries. The 
portion extending from the umbilicus to the placenta is the 
umbilical artery, that within the child's abdomen, the hy- 
pogastric artery. Finally, there are two venous peculiarities: 
first, the placenta is connected with the liver and portal vein 
by the umbilical vein; and secondly, thevmbilical vein is 
connected with the ascending vena cava by the venous duct 
(ductus venosus). 

After detailing the characteristics of the fcetal vascular 
system we are prepared to discuss the course of the circu- 
lation in the child before respiration is established by birth. 

Arterial blood is transmitted from the placenta to the 
foetus by the umbilical vein, which passes through the um- 
bilicus to the liver. Here the branches distribute blood 
directly to the liver ; secondly, mix the arterial blood with 
the blood in the portal vein and then pass it to the liver; 
and thirdly, send a small quantity of arterial blood directly 
into the ascending vena cava by means of the venous duct. 
The blood sent to the liver reaches the vena cava by the 
hepatic veins. 



LARYNX. 169 

In the ascending vena cava the blood, coming fiom the 
liver by the venous duct and the hepatic veins, meets venous 
blood ascending from the lower extremities and abdomen, 
and mingles with it. This mixed, or arterio- venous, blood 
ascends in the vena cava to the right auricle, and is directed 
by the large Eustachian valve across the auricle, and through 
the oval foramen into the left auricle, where it intermingles 
with the little venous blood that comes in the pulmonary 
veins from the lungs. It leaves the left auricle to enter the left 
ventricle and then passes into the aorta, by which the greater 
part of it is distributed to the head and arms. The blood 
sent to the head and arms is thus seen to be anterio-venous 
in character. 

From the head and upper extremities the mixed blood, 
now even more venous than previously, passes into the 
descending vena cava and enters the right auricle, where it 
becomes somewhat mingled with the blood which has come 
up the ascending vena cava. It then passes downwards 
into the right ventricle, and thence into the pulmonary 
artery. The lungs receive very little of th"s blood, because 
respiration is not going on ; but the major part of it is 
carried through the arterial duct (ductus arteriosus) into 
the descending portion of the arch of the aorta. From this 
point it, now almost entirely venous in character, descends 
to the abdomen, pelvis and legs though a large portion of 
it escapes along the two umbilical arteries to the placenta. 

After birth the arterial duct, the venous duct and the 
umbilical vein become obliterated and converted into fibrous 
cords. The umbilical arteries, as far as the top of the blad- 
der, remain open, carry arterial instead of venous blood, 
and receive the name of superior vesical arteries ; while be- 
yond that point they become fibrous cords. The oval fora- 
men be3omes closed, and leaves only a depression, termed 
the oval fossa. 

THE VOCAL AXD RESPIRATORY ORGANS. 

The larynx, trachea, and lungs constitute the vocal and 
respiratory apparatus. The larynx contains the vocal cords, 
and is therefore the special organ of voice. 

LARYNX. 

The larynx is a box composed of cartilages, which are 
joined together by ligament^, moved by muscles, and lined 
with mucous membrane. The laryngeal cartilages are : — 



170 COMPEND OF ANATOMY. 

The thyroid, Two arytenoid, 

The cricoid, Two cartilages of Santorini 

The epiglottis, (or cornicula laryngis), 

Two cuneiform. 

The thyroid cartilage consists of two lateral wing3, or 
sides, united to form a projection in front, called the Adam's 
apple. The po terior angles of each wing are prolonged 
into superior and inferior horns, the inferior of which arti- 
culate with the cricoid cartilage, while the superior are 
attached to the thyro-hyoid ligament. To the inner surface 
of the wings, or alae, where they come together in front, are 
attached, from above downward, the epiglottis, the false and 
true vocal cords, the thyro- arytenoid and thyro-epiglottidean 
muscles. On the external aspect of the wings the attach- 
ment of the following muscles occurs : — Thyro-hyoid, Sterno- 
thyroid, Inferior constrictor of pharynx, Sty^o-pharyngtjus, 
Palato-pharyngeus and Crico-thyioiJ. 

The cricoid is a cartilage shaped like a seal ring, and 
placed below the thyroid, with the narrow part in front. 
There extends between this part and the thyroid the crico- 
thyroid membrane. On the sides of the cricoid are seen 
facets for articulation with the lower horns of the thyroid, 
and on the upper and posterior portion are two articular 
surfaces for the arytenoid cartilages. 

The arytenoid cartilages are pyramidal, with bases 
articulating with the top of the cricoid behind, and apexes 
connected with the cartilages of Santorini. The true vocal 
cords are attached to the anterior angles of their bases ; 
while the false cords are inserted into the anterior surface 
above the true cords. 

The cartilages of Santorini or cornicula laryngis 
are small cartilaginous bodies attached to the apexes of the 
arytenoids. 

The Cuneiform cartilages, or cartilages ofTYrisberg, 
are pieces of cartilage found in the fold of mucous mem- 
brane stretched between the arytenoids and the epiglottis. 

The epiglottis is a cartilaginous lid to the larynx, and is 
shaped like a leaf. It is situated behind the tongue a^d 
attached to the i iside of the front of the thyroid cartilage. 
When the larynx ascends during deglutition, the epiglottis 
is carried downward and backward, so as to close the open- 
ing of the larynx, and prevent the food from entering the 
air passages. 



Intrinsic ligaments -J 



TRACHEA. 171 

The ligaments of the larynx will merely be mentioned, as 
their names show their location. They are — 

-p. , . . ,. , f Thyrohyoid membrane. 

Extrmsjc ligaments Ua - eral ^ hyoid ligaments- 

' Crico-thyroid membrane. 
Capsular ligaments ; between cricoia 
and thyroid, and cricoid and ary- 
. tenoids. 

Superior thyro- arytenoid. 
Inferior thyro- arytenoid (true vocal 

cords). 
Hyo- epiglottic. 
h Thyro- epiglottic. 

THE INTERIOR OF THE LARYNX. 

The cavity of the larynx extends from the superior open- 
ing, under the epiglottis, to the lower edge of the cricoid, 
where the trachea begins. It is divided into two parts by 
the inferior, or true, vocal cords, stretching across antero- 
posterior^. The opening between the cords is narrow, and 
is called the chink of the glottis (rima glottidis). Above 
the true vocal cords, or inferior thyro-arytenoid ligaments, 
are the false vocal cords, which are folds of mucous mem- 
brane covering the superior thyro- arytenoid ligaments. The 
true cords are attached to the base of the arytenoids, and 
the inside of the angle formed by the sides of the thyroid 
cartilage. Between the true and false cords is the ventricle 
of the larynx, the anterior part of which is prolonged up- 
wards and called the pouch of the larynx (sacculus laryngis). 

The muscles, arteries and nerves of the larynx have 
been sufficiently described under the appropriate headings. 

TRACHEA. 

This is a membrano-cartilaginous tube, four and a half 
inches in length, extending from the larynx to the level of 
the third dorsal vertebra, where it divides into the right 
and the left bronchus. It is situated in front of the 
oesophagus, and is formed of sixteen or twenty rings of 
cartilage, which, however, are incomplete. The rings are 
portions of circles, constituting about two thirds of the 
circumference of the tube; the remaining posterior third is 
filled by fibrous membrane, with which the rings are also 
joined together. The trachea divides into two bronchial 



172 COMPEND OF AXATOMY. 

tubes, or bronchi, one of which goes to each lung. The 
bronchi subdivide into small bronchial tubes (bronchioles) ; 
and these finally, after becoming by repeated bifurcation 
smaller and smaller, open into the a ; r vesicles of the lungs. 
The right bronchus is one inch long, and wider and more 
horizontal than the left, which is nearly two inches in 
length. The septum, or partition, dividing the right from 
the left bronchus, lies to the left of the middle line of the 
trachea. 

Longitudinal and transverse muscular fibres are found in 
the membrane completing the posterior wall of the trachea. 

LUNGS AND PLEURAL SACS. 

The organs of respiration are the lungs, which are two in 
number, one situated in each half of the thorax. The right 
and left lungs, covered by a serous membrane, called 
pleura, are separated from each other by the heart and 
other organs in the mediastinal space. Each lung has a 
concave base resting upon the upper surface of the dia- 
phragm, and an apex extending underneath the clavicle up 
into the neck. The outer surface of the lung is convex, 
and corresponds with the contour of the chest wall ; the 
inner, or median, surface is concave, and presents a fissure, 
where the root of the lung is to be seen. The root of each 
lung is formed by the bronchial tube, arteries, veins, nerves, 
and lymphatics, which enter the lung, held together by 
connective tissue and covered by pleura. Each lung is 
divided into an upper and a lower lobe by a fissure, which 
runs obliquely upward and backward in such a manner that 
the greater portion of the upper lobe belongs to the anterior 
part of the lung, and the greater part of the lower lobe to 
the posterior section of the organ. The right lung fre- 
quently has a small portion separated from the anterior 
part of the upper lobe by a secondary fissure. This is 
called the middle lobe. 

Structure. — The lungs are composed of lobules, each of 
which consists of a ramification of a small bronchial tube 
with its terminal air cells, of pulmonary and bronchial 
capillaries, both arterial and venous, and of nerves and 
lymphatics. 

The pleural investment of each one of the lungs is a 
serous sac, having a parietal layer (costal pleura) and a 
visceral layer (pulmonary pleura) with a pleural cavity 
between them. By these layers the inside of the thoracic 



MEDIASTINAL SPACE. 173 

wall and the external surface of the lung are covered by a 
serous membrane. The pleural membranes of the two 
sides are distinct from each other, and are shut sacs ; the 
space between the two sacs in the middle line of the body 
is called the mediastinum. The mediastinal space is 
divided into the anterior, the middle and the posterior 
mediastinum. 

Let us follow the reflections of the pleura by beginning 
at the sternum. It passes around the inside of the thoracic 
wall to the side of the spinal column (costal or parietal 
layer) ; from here it passes upon the posterior surface of 
the root of the lung ; then around the convex surface, or 
outside, of the lung to the front, and bending around the 
anterior thin edge of the organ, it reaches the front of the 
root which it covers (visceral or pulmonary layer), and then 
passes over the pericardium to the sternum. From the 
back of the root of the lung a fold descends to the dia- 
phragm, called the broad ligament of the lung. The dia- 
phragm receives upon its upper surface an investment of 
the pleura, which is a portion of the parietal layer. 

MEDIASTINAL SPACE. 

The mediastinum is the space left in the middle line of 
the chest between the two pleural sacs ; it extends from the 
sternum to the vertebral column and is divided into the 
anterior, middle and posterior portions. It contains all the 
thoracic viscera except the lungs. 

The anterior mediastinum contains : — 

1. Muscles (Sterno-hyoid, Sterno-thyroid, Tri- 

angular of sternum). 

2. Internal mammary vessels. 

3. Thymus gland. 

The middle mediastinum contains : — 

1. Heart and pericardium. 

2. Great arteries and veins. 

3. Bifurcation of trachea. 

4. Phrenic nerves. 

The posterior mediastinum contains : — 

1. Descending aorta. 

2. (Esophagus. 

3. Pneumogastric and splanchnic nerves. 

4. Azygos veins. 

5. Thoracic duct. 



174 COMPEND OF ANATOMY. 

THYROID AND THYMUS GLANDS. 

These glands have no ducts and their function is un- 
known. 

The thyroid is located in front, and at the sides of the 
upper part of the trachea, and consists of two lobes joined 
by an isthmus. Its structure is that of an aggregation of 
small closed vesicles, surrounded by capillary plexuses and 
held together by connective tissue. 

The thymus is an organ of infancy, being fully developed 
at the age of two years, but becoming atrophied as the child 
advances to puberty. It lies in the anterior mediastinum 
behind the sternum, from the level of the fourth costal car- 
tilage to the lower border of the thyroid gland. It has two 
lateral lobes, consisting of lobules held together by connec- 
tive tissue. Each lobule contains a small cavity, and all 
the cavities of each half of the gland open into a large 
cavity occupying the centre of each lateral lobe. The cen- 
tral cavity contains a white fluid. The gland, however, has 
no duct. 



KIDNEYS. 175 



CHAPTER VIII. 



THE URINARY ORGANS. 



KIDNEYS. 



The urinary organs are the two kidneys, the ureters, blad- 
der and urethra. The kidneys are the glands which secrete 
the urine, and have each a duct called the ureter, that conveys 
the urine to the bladder. The bladder is a reservoir in which 
the urine is retained until discharged through the urethra. 

The kidneys lie in the posterior portion of the abdomen 
behind the peritoneum, and extend from the level of the 
eleventh rib nearly to the crest of the ilium. Each kidney 
is one inch thick, two inches wide, and four inches long; 
and weighs from four to six ounces avoirdupois. The supra- 
renal capsule, a ductless gland, lies just above the upper 
end of the kidney. The external border of the kidney is 
convex, the internal concave and has a notch in it called 
the hilum. Through this hilum the renal artery, vein, and 
the ureter communicate with the interior of the organ ; the 
vein is usually the most anterior and the ureter the most 
posterior of these structures. 

Structure. — If a section of the kidney be made it will 
be seen' that it consists of a solid portion, and a cavity sit- 
uated at the inner border and communicating with the ureter. 
This cavity is in fact the dilated, or funnel-shaped, beginning 
of the ureter or duct of the kidney. This cavity is called 
the pelvis of the kidney ; and is seen to be divided near its 
circumference into three smaller cavities or pouches, called 
infundibula (singular, infundibulum). Each infundibulum 
is subdivided in smaller pouches called cups, or calices (sin- 
gular, calix). Into these calices open the orifices of the 
pyramids of the kidney, which show as little openings at the 
apexes of projections called papillae. 

Looking at the substance of the kidney, we find it to be 
composed of the outer, or cortical, portion, which is sur- 
rounded by a fibrous capsule ; and of the inner, or medul- 
lary portion, consisting of conical pieces named the pyra- 



176 COMPEND OF ANATOMY. 

mids of the kidney. It is the apexes of these pyramids 
which present the orifices, opening into the calices, of which 
we have spoken. The cortical is about one-half as wide as 
the medullary portion, though it, in places, passes between 
two pyramids down to the pelvis. It consists of convoluted 
and straight uriniferous tubules, blood vessels, nerves, lym- 
phatics, and small masses, called Malpighian bodies. The 
medullary portion consists of about a dozen pyramids with 
their bases towards the circumference of the organ. Each 
pyramid consists of vessels, looped tubes of Henle, and 
straight uriniferous tubules converging to discharge the 
urine at the apex of the pyramid into the calix and infundi- 
bulum. 

When the kidney structure is examined microscopically 
the red Malpighian bodies are found to consist of a glome- 
rule of capillary arteries and veins, named a Malpighian 
tuft, and a membranous envelope called the Malpighian 
capsule. The Malpighian bodies are found only in the 
cortical substance, and the capsule is the beginning of a 
uriniferous tubule. The urine-bearing tubules, after leaving 
the capsule, become convoluted, and then open into a larger 
straight tube, which continues through the cortical substance 
and finally passes into the medullary or pyramidal portion 
and unites with other straight tubes. These at last open 
upon the papillaB, and discharge the urine into the subdi- 
visions of the pelvis. Some of the tubules, before joining 
the straight tube, send long loops downwards into the 
medullary portion, and then open into the straight tubes, as 
usual. 

The ureter proper extends from the pelvis of the kidney 
to the base of the bladder, and is a tube about eighteen 
inches long and as large as a goose quill. It has a fibrous, 
a muscular and a mucous coat ; and is continuous in struc- 
ture and function with the pelvis of the kidney. It enters 
the bladder obliquely, so that the portion within the bladder 
wall is nearly an inch long. By this arrangement the blad- 
der when distended compresses the orifice, and prevents any 
urine being forced backwards into the ureter. 

SUPRA-RENAL CAPSULES. 

One of these glands, as they are called, lies in front of the 
top of each kidney, and they are, therefore, described at this 
time, though having nothing to do with the urinary secre- 
tion. They have no duct, are yellowish in color, weigh one 



BLADDER. 177 

or two drachms, and are one or two inches long. They are 
composed of a yellowish cortical portion, which is. of course, 
the external, and a pulpy, dark brown medullary portion. 

BLADDER. 

The reservoir into which the urine is discharged by the 
ureters is called the bladder, which is a muscular bag cap- 
able of containing about a pint, when moderately fall. It. 
lies in the pelvis behind the pubes and in front of the rectum. 
In the female it is situated between the pubes and the uterus 
and vagina. The bladder has four coats: a serous, or peri- 
toneal, which covers only the posterior wall; a muscu, 
consisting of longitudinal and circular fibres ; a cellular, or 
sub-mucous coat, of connective tissue; and a mucous lining 
membrane, which has small glands in it, and is covered with 
epithelium. Around the neck of the bladder the circular 
muscular fibres are very abundant and form the sphincter 
muscle of the bladder. 

The bladder has a summit or apex, a body, a base, and a 
neck. The summit is connected with the umbilicus above 
by the urachus, a cord, the remains of a tubular structure of 
early foetal life; and by the obliterated hypogastiic arteries 
which lie at the sides of the urachus. The main portion of 
the organ is called its body and is covered posteriorly by the 
peritoneum. Along its sides the ducts of the testicle, com- 
ing from the internal inguinal rings;, descend to the base of 
the bladder. The base, or fundus, is the lower posterior 
part, which lies against the rectum in the male, against the 
neck of the uterus and the vagina in the female. The ure- 
ters pass obliquely through the wall of the bladder near the 
base. The neck of the bladder is the narrow outlet which 
is continuous with the urethra, and is in the male surrounded 
by the prostate gland. 

The bladder is held in position by five true ligaments, and 
five false ligaments, or folds of peritoneum. The following 
is a description of the true ligaments: The anterior, or 
pubo-prostatic, are two in number and extend, on each side, 
from the pubes to the front of the neck of the bladder and 
prostate gland. The lateral, also t^vo in number, are 
attached to the sides of the prostate and sides of the base of 
the bladder. The obliterated urachus, ascending to the 
umbilicus from the summit of the organ, is also considered 
a ligament, a superior true ligament. The five false liga- 
ments are formed by folds of peritoneum, and are two pos- 



178 COMPEND OF ANATOMY. 

terior, two lateral and one superior. The posterior are 
between the rectum and back of the bladder , or in the 
female, between the uterus and bladder, and contain the 
obliterated hypogastric arteries and the ureters. The lateral 
false ligaments extend from the iliac fossa to the side of the 
bladder, while the single superior one is attached to the 
top of the bladder and the umbilicus, covering the urachus 
and obliterated hypogastric arteries. The bladder is thus 
firmly supported. 

The interior of the organ will now require description. 
It is lined by mucous membrane, which is continuous with 
that of the urethra and of the ureters and kidneys. Its epi- 
thelium is an intermediate form between the columnar and 
the squamous varieties. Behind the opening into the urethra 
there is a smooth surface of triangular shape, having the 
urethra at the anterior angle, the orifices of the ureters at 
the other angles. The space is called the vesical trigone. 
At its apex there is a little elevation produced by the pros- 
tate, called the uvula of the bladder. 

URETHRA. 

The canal from the bladder to the urinary meatus is called 
the urethra, and has a length in the male of eight or nine 
inches, in the female of an inch and a half. The female 
urethra is of simple construction, but that of the male re- 
quires a detailed description. When the penis is erect, the 
male urethra presents one curve, which is in the posterior 
portion and has its concavity looking upwards. During the 
ordinary dependent position of the pens the urethra has an 
additional anterior curve, with the concavity downwards. 

The urethra is divided into the prostatic, membranous and 
spongy portions ; as named from the structures through 
which it passes. The prostatic portion is an inch and a 
quarter long, and lies within the prostate gland, which it 
traverses from base to apex, near its upper surface. Upon 
the floor is seen a longitudinal ridge, the verumontanum, or 
caput gallinaginis, with a depression on each side (prostatic 
sinuses), into which the prostatic ducts, for the most part, 
open. In front of and beneath the verumontanum is another 
depression, the sinus pocularis, within which are the orifices 
of the seminal ejaculatory ducts. The membranous urethra 
extends from the prostatic portion to the bulb of the spongy 
body of the penis, and is the narrowest part of the urethra, 
except the meatus. It is three-quarters of an inch in length 



MALE GENITAL ORGANS. 179 

along its roof 7 but only a half inch long on its floor, because 
the bulb projects backwards under it. It is about one inch 
below the arch of the pubes, lies between the anterior and 
posterior layers of the triangular ligament, and is surrounded 
by the Compressor muscle of the urethra. 

The spongy or remaining portion of the urethra is about 
six inches long and traverses the spongy body of the penis. 
Within the bulb, and also just behind the external orifice, 
or meatus, the canal shows dilatations. • The anterior one is 
termed the navicular fossa; the dilated portion in the bulb 
has the orifices of Cowper s gland opening into it, and it is 
often called the bulbous urethra. The slit-like opening of 
the urethra is the urinary meatus and has two lips. The 
urethra is lined with mucous membrane, continuous with 
that of the bladder and of the outside of the glans, or head, of 
the penis. It has numerous mucous glands ; the large orifice 
of one of these, situated on the roof cf the urethra about an 
inch and a half from the orifice, is called the lacuna magna. 
The wall of the posterior portions of the canal is supplied 
with muscular and erectile tissue. 

THE MALE GENITAL ORGANS. 
PROSTATE GLAND AND COWPER'S GLANDS. 

The prostate is composed of glandular tissue and muscular 
fibres ; the former consists of small follicles, secreting a 
milky fluid and opening into the prostatic sinuses of the 
urethra ; the latter are circular and pass around the urethra. 
The prostate surrounds the neck of the bladder, or rather 
may be said to lie in front of the neck of the bladder and to 
surround the first part of the urethra. It is pyramidal in 
shape, with the apex directed forwards, and is pierced 
antero-posteriorly, near its upper surface, by the urethra. 
It is an inch and a half wide at the base and one inch long, 
and consists of two lateral lobes, with sometimes a central, 
or middle lobe. Cowper s glands are two small bodies lying 
between the two layers of the triangular ligament, and having 
ducts opening into that part of the spongy urethra which is 
often called the bulbous urethra. 

PENIS. 
This organ has a root, glans or head, and body. The root 
is attached to the descending portions (rami) of the pubic 
bone by the legs (or crura) of the penis, which are the pos- 
terior ends of the cavernous bodies of the organ. It is at- 



180 COMPEND OF ANATOMY. 

tached also to the symphysis of the pubes by the suspensory 
ligament. The glans is the free extremity of the penis 
and is somewhat conical. Its base has a rounded border 
called the corona, behind which is a groove ; while at 
its apex is the orifice of the urethra, the urinary meatus. 
The - glans is invested by mucous membrane, and has a 
movable sheath, or covering, cutaneous on the external 
aspect, but mucous on the inside, to which the name fore- 
skin, or prepuce, has been given. A fold of mucous mem- 
brane like a ligament passes from the lower part of the 
meatus to the prepuce ; it is the frenum of the prepuce. 
The posterior part of the glans and the groove behind are 
supplied with sebaceous glands, secreting a peculiar cheesy 
material. 

The body of the penis is the portion between the root 
and the glans ; its upper surface is the dorsum. It con- 
sists of two parallel cylindrical bodies, the cavernous 
bodies (corpora cavernosa) forming the upper portion, and 
the spongy body (corpus spongiosum) lying below in the 
groove between them. The two cavernous bodies consist 
of fibrous and erectile tissue, arranged so as to leave 
numerous meshes or openings in the interior ; the bodies 
are separated from each by the pectiniform septum, and 
are attached posteriorly to the pubes, by their continuations, 
the crura, and by the suspensory ligament. The spongy 
body (corpus spongiosum) commences as the bulb at the 
triangular ligament, runs forward in the groove beneath 
the two cavernous bodies, and finally expands into the 
glans, or head, of the penis, which covers the ends of the 
cavernous bodies. It is perforated by the urethra. The 
bulb is covered by the Accelerator of the urine muscle. 
The spongy body is somewhat similar in structure to the 
cavernous, being composed of fibrous and erectile tissue. 
The erectile tissue is made up of innumerable venous 
plexuses. 

TESTICLES, SCROTUM, AND SEMINAL VESICLES. 

The testicles are the organs which secrete the seminal 
fluid, and are suspended in a bag, or pouch, called the 
scrotum. The testicle hangs from the spermatic cord, which 
contains the vessels, lymphatics and nerves of the testicle, 
and the duct carrying the semen from the organ. During 
the early part of foetal life the testicles are developed in 
the lumbar region behind the peritoneum, in front of and 



MALE GENITAL ORGANS. 181 

below the kidneys ; but during the last three months of 
intra-uterine life they descend into the scrotum, passing 
through the abd-jminal wall by means of the inguinal canal. 
The tes icle is guided, or pulled, in this direction by a cord, 
attached to the testicle and the bottom of the scrotum, called 
gubernaculum testis. The structures going to, and coming 
from the testicle, held together by connective tissue, remain 
in the canal as the spermatic cord, which extends from the 
internal abdominal ring to the back of the testicle. At this 
ring the components of the cord separate, for the arteries 
and veins go to be connected with the abdominal vessels, 
and the seminal duct (vas deferens) descends into the pelvis 
to the back of the bladder. The arteries of the cord are the 
spermatic, cremasteric, and aitery of the vas deferens. The 
ingirnal canal is an oblique opening in the abdominal wall, 
through which the cord passes. Its external opening, or 
ring, is in the tendon of the External oblique muscle, just 
above the crest of the pubes, while the internal is in the 
transversalis fascia, under the arching fibres of the Trans- 
versalis, about half an inch above the middle of Poupart's 
ligament. The outer ring is closed by the intercolumnar 
fascia, the inner by the funnel-shaped process of the trans- 
versalis fascia (infunclibuliform fascia). 

The scrotum is a pouch, divided by a median septum into 
two sacs, each containing a testicle and the lower end of the 
spermatic cord. It is composed of skin and the dartos, 
which is a variety of superficial fascia containing involuntary 
muscular fibre. The median line seen on the e xterior is the 
raphe. The left testicle and the corresponding side of the 
scrotum hang lower than the right. 

The testicle is a gland, made up of the body and the epi- 
didymis ; of which the latter is posterior, and has the sper- 
matic cord attached to its- lower extremity. The coverings 
of the organ are : the vaginal, or serous, tunic, derived from 
the peritoneum during the descent of the testicle, which has 
a parietal and visceral layer and covers the front and sides 
of the gland ; the albugineous, or fibrous, tunic, which gives 
shape and firmness to the organ, and sends in processes to 
form a vertical septum and smaller partitions between the 
various lobules of the gland ; and finally the vascular tissue 
carrying the blood vessels. 

The minute structure of the testicles consists of the secret- 
ing portion, or lobules, and the semen-carrying ducts. The 
lobules number three or four hundred, consisting of convo- 



182 COMPEND OF ANATOMY. 

luted semeniferous ducts, and discharge the semen into 
straight ducts (vasa recta) ; those near the back of the body 
of the testis anastomose, forming a network of tubules (rete 
testis I. At the upper and posterior corner of the body the 
rete testis terminates in twenty efferent tubes, or ducts, 
which pierce the albugineous tunic and empty into the larger 
globe (globus major) of the epididymis, which is formed of 
an intricate interlacing of these ducts. These finally empty 
in a tube, about twenty feet long, which is tightly twisted 
upon itself to form the body and the*inferior lesser globe 
(globus minor) of the epididymis. From this lower point 
the tube is continued as the vas deferens, or excretory duct 
of the testicle, which passes up the back part of the sper- 
matic cord, and enters the abdomen by the inguinal canal. 
After reaching the internal inguinal, or abdominal, ring, it 
descends into the pelvis, passes along the side and b ck of 
the bladder to its base, where it becomes dilated, and then, 
having united with the duct of the seminal vesicle, forms the 
ejaculatory, or common seminal, duct. The vas deferens is 
a tube two feet long, having a thick wall, a small calibre, 
and a cellular, a muscular and a mucous coat. 

SEMINAL VESICLES. 

These are two reservoirs, 2} inches long, each formed 
from an irregularly dilated and convoluted tube. They lie 
behind and under the base of the bladder, with their anterior 
extremities converging towards the ducts of the testicles 
(vasa deferential which lie between the seminal vesicles. 
The duct of each vesicle unites, at the base of the prostate, 
with the duct of the corresponding testicle, to form the 
ejaculatory duct, which is three fourths of an inch long, and 
opens into the urethra in front of the verumontanum at the 
sinus pocularis 

THE FEMALE GENITAL ORGANS. 

The external genitals, or vulva, of the female consist of 
the mons Veneris, the greater lips (labia majora ; singular, 
labium majus), the lesser lips (labia minora; singular, 
labium minus), the clitoris, the urinary meatus and the 
opening of the vagina. The internal organs are the vagina, 
and uterus with its appendages. The mons Veneris is the 
cushion of fat covering the pubes and supplied with hair: 
the greater lips are two muco- cutaneous elevations extend- 



FEMALE GENITAL ORGANS. 183 

ing from the mons to the perineum, where they have a 
transverse fold between them, the fourchette, behind which 
is a depression called the navicular fossa. The lesser lips 
(labia minora or nymphaei are two folds of mucous mem- 
brane, which extend from the clitoris downwards to become 
merged into the labia majora. The upper extremities of the 
lesser lips form the prepuce and frenum of the clitoris. The 
clitoris is erectile and analogous to the penis, having two 
cavernous bodies and a glans. The posterior portion of the 
cavernous body on each side is attached to the ramus of the 
pubes and of the ischium, and is covered by the Erector 
muscle of the clitoris. Between the clitoris and vaginal 
opening is a space, called the vestibule, within which the 
urinary meatus is seen. It is one inch b°low the clitoris. 
The female urethra perforates the triangular ligament as in 
the male, but is only an inch and a half long, and is very 
distensible. Below the meatus is the large oval aperture of 
the vagina, often partly closed by the semilunar bymen, a 
mere fold of mucous membrane. Instead of the hymen a 
few granular elevations may at times be found ; these are the 
myrtiform caruncles. On each side of the lower end cf the 
vagina is a gland, analogous to Cowper's gland in the male, 
termed the vulvo-vaginal, or Bartholine's. gland. 

The internal org -ins are the vagina, and the uterus with 
its appendages. The vagina is a canal leading from the 
vulva to the neck of the uterus, and lies between the 
bladder and rectum. It is a curved tube ; its anterior wall 
measures four, and the posterior five or six inches in length. 
It is attached around the end of the uterine neck, with the 
posterior wall extending higher on the uterus than the 
anterior. Its walls are made up of an external or muscular 
coat, an erectile and a mucous coat. Between the upper 
vagina and the rectum there is a pouch of peritoneum, 
called Douglas's cul-de-sac. The mucous membrane pre- 
sents many transverse ridges, called rugae, and the lower 
end of the tube is surrounded by the Sphincter muscle, ana- 
logous to the Accelerator of the urine in the male. 

UTERUS AND ITS APPENDAGES. 

The womb, or uterus, is the organ in which the foetus is 
developed, and by which it is finally expelLed at the com- 
plet : on of gestation. It lies in the pelvis above the vagina, 
between th.3 bladder and rectum, with its axis directed 



181 COMPEND OF ANATOMY. 

towards the umbilicus. It is rudely triangular, and resem- 
bles in shape a flattened pear ; its dimensions are as fol- 
lows : thickness one, breadth two, length three, inches. The 
upper, broad portion is the fundus; the lower, constricted 
part the neck, ar;d the remainder is the body. To the upper 
lateral corners are attached the Fallopian tubes, with the 
round ligaments in front and the ovarian ligaments behind. 
The lower angle, or neck, of the uterus projects partly into 
the vagina, and has at its extremity the mouth of the uterus 
(os uteri), the external orifice of the uterine cavity. The 
cavity of the uterus is triangukr in shape, with its superior 
angles opening into the Fallopian tubes, and the inferior 
(cervix) at the external mouth, spoken of above. Where 
the body and cervix unite there is a constriction of the cavity 
called the internal mouth (os internum). The uterus has a 
serous coat, covering all but the lower anterior portion of 
the organ, a thick and powerful muscular coat of unstriped 
fibres, and a mucous lining or coat. It is held in position 
by ligaments and by the vagina, which allow, however, 
considerable latitude of motion. The ligaments formed by 
peritoneum are the two anterior or vesico-uterine, two pos- 
terior or recto-uterine, and two lateral or broad, extending 
from uterus to sides of pelvic cavity. The two round liga- 
ments are not formed of peritoneum, but are cords coming 
from the upper angles of the womb, to pass through the in- 
guinal canals and become lost in the labia majora. Into 
the canal there passes a tubular process of peritoneum, 
called the canal of Nuck. The arteries cf the uterus are the 
uterine and the ovarian ; the veins are large, and in the 
gravid uterus are called sinuses. 

The fallopian tubes, or oviducts, are two tubes four 
inches Ion?, placed in the upper margin of the broad liga- 
ments, and attached to the uterus at the upper angles in such 
a way as to communicate with the two upper angles of the 
uterine cavity. The opening into the uterus is the ostium 
internum, and is narrow ; the other orifice, or ostium ab- 
dominale, is trumpet shaped and opens into the peritoneal 
cavity. This is called the fimbriated extremity, because it 
has a number of fringe-like processes. This fimbriated ex- 
tremity, at the periods of ovulation, attaches itself to the 
ovary, so that the ovule is passed along the tube into the 
uterus. The Fallopian tubes have serous, muscular and 
mucous coats. 

The ovaries, two in number, are of an almond shape, 



MAMMARY GLANDS. 185 

and pkced in the posterior part of the broad ligament. 
They are attached to the upper angles of the womb by the 
two ovarian ligaments The ovary, except in front, is 
covered by the peritoneum, beneath which is the albugineous 
tunic enclosing the soft fibrous tissue, or stroma. In the 
meshes of the stroma are the Graafian vesicles, which at the 
time of menstruation burst and discharge the ovule into the 
opening of the Fallopian tube. 

MAMMARY GLANDS. 

The breasts, or mammary glands (mammae), are the organs 
secreting milk for the nour shmenfc of the newly-born child. 
They exist as rudimentary organs also in the male. The 
space between the third and sixth ribs and from the sternum 
to the lateral aspect of the chest is occupied on each side by 
an elevation, the mammary gland-of tbat side. The gland 
is external to the Greater pectoral muscle, from which it is 
separated by the deep layer of superficial fascia. Upon its 
summit is a conical eminence, covered by sk'n resembling 
mucous membrane, surrounded by an area of pinkish or 
dark-colored skin. This is the nipple ( mammilla }, encircled 
by the areola. The orifices of the milk ducts are seen on 
the surface of the ripple. The gland is composed of lobes, 
formed from lobules; and the lobules consist of vesicles 
opening into small lactiferous ducts. These, by coalescence, 
form larger ducts, until about twenty main ducts are finally 
obtained. These converge towards the nipple, under which dila- 
tatiors to act as reservoirs occur, and then the ducts onen 
upon the surface of the nipple. The milk ducts are lined by 
mucous membrane. 



186 COMPEND OF ANATOMY. 



CHAPTER IX. 



THE ORGANS OF SENSE. 

The five senses are: 1, touch, located in the skin; 2, taste, 
belonging to the tongue ; 3, smell, pertaining to the nose ; 
4, sight, which is the special function of the eye; and 5, 
hearing, belonging to the ear. 

SKIN. 

The skin, in addition to being the organ of the tactile 
sense, or touch, is an absorbing and excretory organ, and 
also serves as a protection to underlying structures. It is 
composed of two layers, the true skin, cutis vera, or derma, 
and an overlying layer, called the cuticle, or epidermis. 
The true skin, or derma, is tough and flexible, consisting 
principally of white fibrous tissue with some yellow elastic 
tissue; and is divided into the corium, or lower part, and 
the papillae. The corium may be regarded as the ground- 
work of the skin, and varies in thickness in different local- 
ities. The papillae are small, sensitive and \ascular ele- 
vations on the upper surface of the corium, and are the 
organs of touch. They are xio^ °f an i ncn high and con- 
tain vessels and nerve terminations; the nerves may, in 
very sensitive regions, have tactile corpuscles, Pacinian 
bodies, etc., connected with them in the papillary layer. 
The epidermis, or cuticle, is epithelial in structure and lies 
upon the derma, with little processes fitting into the crevices 
between the papillae. Its lower and softer layers are called 
the rete mucosum, and contain most of the cutaneous pig- 
ment found in the African and other dark races. The lippf r 
layers are hard, and may even become horny, as upon the 
soles and palms. 

The skin has appendages for the purposes of secretion and 
protection, which must be mentioned; they are the nails, 
hair, sweat and sebaceous glands. 

The nails are horny structures on the back of the toes 
and finger tips, with a root, fitting into a groove in the skin, 
a body, and a free edge. The nail is a sort of modified epi- 



ORGANS OF SENSE. 187 

dermis, and has beneath it the cutis forming a matrix, from 
which the nail is developed. The papillae und.r the body 
of the nail near the root are less vascular than further for- 
ward ; hence a whitish crescent is seen through the trans- 
pare it nail at the base. This is the lunula. 

The hairs are also modifications of epidermis, consisting 
of a root seated in the skin, a shaft and a point. The root 
is a bulbous extremity placed in a follicle of thg skin, lined 
with epidermis. The follicle may extend into the tissue 
beneath the skin. The shaft has often a dark portion in the 
centre, called the medulla, and always a fibrous body with 
a cortex, or external covering. 

Sebaceous Glands. — These are small glands, very abun- 
dant in the scalp and face, and around the anus, nose and 
ear, but absent in the palms and soles. They open by 
ducts into the hair follicles, or on the surface. The Mei- 
bomian glands of the eyelids are very large sebaceous 
glands. 

Sweat Glands. — The sudoriferous glands secrete the 
sweat, by which a large portion of the deleterious ingre- 
dients of the blood is thrown out of the body. They are 
usually situated in the subcutaneous areolar tissue, and are 
small reddish bodies, consisting of twis'ed tubules. The 
duct of a sweat gland ascends to the surface through the 
skin, being at first tortuous and then becoming straight. 
Some of them become rather tortuous again just before 
opening on the surface. 

TONGUE. 

The tongue is the organ of taste and lies in the floor cf 
the mouth. It has a base or root, a body, and a point or 
tip. Its root is attached to the hyoid bone by numerous 
muscles, to the epiglottis by three folds of mucous mem- 
brane (glosso-epiglottic ligaments), and to the palate and 
pharynx by the pillars of the fauces. The inferior surface 
i» fastened to the inside cf the lower jaw at the symphysis 
by the Genio-hyo-glossus muscles, and by the mucous mem- 
brane forming the frenum. The tongae is composed of 
muscles, covered by mucous membrane which presents a 
median raphe on the top of the organ This membrane 
consists, like skin, of a cutis with papillae, and an epithelial 
layer on top. There are three varieties of these papillae : 
1, the circumvallate or largest ; 2, the fungiform ; 3, the 
filiform or smallest. The circumvallate papillae arc about 



188 COMPEND OF AX ATOMY. 

ten in number, and are arranged at the back of the dorsal 
surface of the tongue, like a letter V with the apex directed 
backwards 5 at the point of the V there is a depression 
called the foramen caecum. The fungiform papillae are 
seattered over the organ, but are especially seen at the tip 
and sides. They are deep red in color. The filiform are 
very small and numerous, and at the back are placed in 
lines parallej to the circumvallate papillae, but near the tip 
become more irregular in their arrangement. In the cir- 
cumvallate, and in some of the fungiform, papillae flask- 
shaped bodies, called taste corpuscles, have been described. 
The surface of the tongue is supplied with mucous glands 
and scaly epithelium. 

NOSE. 

The organ of the sense of smell is the nose, consisting of 
the external prominence, known as the nose proper, and 
the two nasal fossae, or cavities, separated by a median wall, 
the septum. The root of the nose is attached to the fore- 
head ; the base is attached to the upper lip, and presents 
two " openings, the nostrils, separated by the lower end of 
the septum, called here the columna. The movable exter- 
nal sides of the nostrils are called the wings (alae) of the 
nose. The two sides of the nose form on top the dorsum, 
or bridge, while the point is denominated the lobe. 

The nose proper, that is, the exte.rnal portion, is formed 
of bones and cartilages, connected by cellular tissue, covered 
by skin externally, and lined by mucous membrane. The 
bones are the nasal and the nasal processes of the superior 
maxillary; the cartilages are five, two upper lateral, two 
lower lateral, and the cartilage of the septum. There are 
usually several small sesamoid cartilages between the lower 
lateral cartilage of each side and the nasal process of the 
corresponding upper maxillary. The cartilage of the sep- 
tum lies in the middle line, below and behind the nasal bones 
and lateral cartilages, and fits into the notch between th«e 
perpendicular plate of the ethmoid and the vomer and pal- 
ate processes of the upper jaw. It frequently deviates a 
little to the side, instead of lying exactly in the median line. 
The small muscles of the nose have already been described 
in the chapter on muscles. They produce very little motion 
of the cartilages of the human nose. 

Nasal Fossae. — These two cavities open in front at the 
anterior nostrils (nares), and communicate behind with the 



EYE. 189 

pharynx by the posterior nostrils. They arc lined by a 
mucous membrane, called the pituitaiy or Schneiderian 
membrane, which is so thick that the orifices opening into 
the nasal fossae are greatly diminished in calibre. It is con- 
tiuuous with the mucous membrane lining the pharynx, 
middle ear, and eye. The meatuses and the boundaries of 
the nasal fossae have been described under the bones of the 
head. 

EYE. 

The eye is the organ of vision, and is contained in a coni- 
cal cavity called the orbit. It is spherical in shape, with a 
segment of a smaller sphere placed in front. The optic nerve 
enters the back of the e3 r eball a little to the inner side. The 
eye consists of three coats, containing refracting media 
called humors. The three coats are : — 

1. Sclerotic and cornea. 

2. Choroid, iris, ciliary muscle and processes. 

3. Retina. 

The humors are : — 

1. Aqueous. 

2. Crystalline lens and cajDSule. 

3. Vitreous. 

The sclerotic is a strong, white, fibrous coat, which gives 
shape and protection to the eyeball ; to it are attached the 
muscles which move the eye. The inner surface of the 
sclerotic is brown in color and attached to the outside of 
the choroid by a layer of connective tissue, called the lamina 
fusca. Through the posterior portion of this coat, a little 
to the nasal side, the fibres of the optic nerve enter, giving 
at the point of entrance a sieve-like appearance. This 
sieve-like fascia is called the lamina cribrosa, and has at its 
centre an opening larger than the rest, called the porus 
opticus, which transmits the central artery of the retina. 
In front the sclerotic overlaps the cornea, with which it is 
continuous. 

The cornea is transparent and occupies the front of the 
ball, projecting like a watch crystal set in the case of a 
watch. The cornea is made up of five layers. The central 
layer is of fibrous tissue, in front of which is an elastic layer, 
covered by mucous membrane (the epithelial layer of the 
conjunctiva) ; behind the central layer is a posterior elastic 
layer, and behind it a serous membrane (of Descemet). 

The second coat is formed by the iris and ciliary processes 



190 COMPEND OF ANATOMY. 

in front, and the choroid behind. The ciliary muscle and 
ligament are situated at the point where the sclerotic, and 
cornea, choroid, and iris come together. 

The choroid is the vascular and pigmented coat of the 
eye, and terminates at the ciliary ligament by being folded 
inwards to form the ciliary processes. It has three layers ; 
the external is composed principally of the vorticose veins, 
the middle layer consists of a plexus of b'ood vessels and is 
termed the tunica Ruychiana, the internal or pigmentary 
layer consists of cells filled with pigment granules. This 
last layer is believed by some to be a part of the retina. 
The ciliary processes are arranged around the edge of the 
lens behind the iris ; they are seventy-five in number, and 
fit into folds of the suspensory ligament of the lens. They 
are really portions of the middle and internal layers of the 
choroid, which have been turned inward. 

The iris is the colored muscular curtain suspended in 
the aqueous humor in front of the lens, with an aperture in 
it called the pupil. Its circumference is attached to the 
choroid and the ciliary ligaments. Its posterior surface is 
covered with purplish pigment named the uvea. The iris 
consists of fibrous tissue, pigment cells and involuntary 
muscular fibre ; some of these fibres are circular, constitut- 
ing the sphincter cf the pupil, while others are radiating 
fibres and form the dilator of the pupil. In the foetus a 
delicate vascular tissue closes the pupil, constituting the 
pupillary membrane. 

Ciliary ligament axd muscle — The ciliary ligament 
is a ring of circular fibres surrounding the iris, and joining 
the external and middle tunics of the eyeball. Where it 
connects with the sclerotic, a small channel runs between 
the two, the circular sinus of the iris. The ciliary mus- 
cle surrounds the circumference of the ir's near the 
ligament, is composed of involuntary muscular fibres, and 
regulates the convexity of the lens during efforts of accom- 
modation. 

The retixa is the semi-transparent nervous coat upon 
which images are received, and lies between the choroid 
and the hyaloid membrane surrounding the vitreous humor. 
"Where it terminates in front, near the ciliary ligament, it 
has an irregular edge called the serrated border (ora serrata) ; 
at its centre posteriorly is the yellow spot (macula lutea), 
with a depression in its centre, termed the central pit 
(fovea centralis). A little to the nasal side of the yellow 



EYE. 101 

spot is the optic nerve entrance. The retina consi ts of 
three layers, which have, however, been sub-divided into 
many more. They are : — 

1. External, or layer of rods and cones (Jacob's mem- 
brane . 

2. Middle, or granular layer. 

3. Internal, or nervous layer. 

The external layer is contiguous to the choroid, the mid- 
dle is composed of granules, the internal is semi-transparent, 
and consists of expansions of the optic nerve fibrils and of 
nerve cells. Between the external and middle layers is sit- 
uated the external limiting membrane, between the internal 
layer and the hyaloid membrane of the vitreous is the inter- 
nal limiting membrane. 

The central artery and vein of the retina distribute 
branches over its surface and in its internal or nervous 
layer. The artery enters, and the vein makes its exit from, 
the globe by the porus opticus in the middle of the optic 
nerve entrance. 

The humors of the eye are the aqueous, vitreous, and 
crystalline lens, with its capsule. The aqueous humor, 
which resembles water in composition, fills the space be- 
tween the cornea and crystalline lens. This space is divided 
by the iris into an anterior and posterior chamber. The 
vitreous humor, or body, enclosed in the hyaloid membrane, 
is between the retina and lens ; it is an albuminous fluid 
resembling jelly, with a depression in front, in which lies 
the lens surrounded by its capsule. The crystalline humor, 
which is a double convex lens, with an enveloping capsule, 
lies behind the pupil in the concavity in the front of the 
vitreous body, with the ciliary processes surrounding its 
margin. The lens is held in position by the capsule, an 
elastic enveloping membrane, and by the suspensory liga- 
ment of the lens. The suspensory ligament joins the an- 
terior edge of the retina with the front of the periphery of 
the lens, and there remains between this ligament and 
the hyaloid membrane an opening surrounding the lens, 
termed the canal of Petit. The lens is a transparent, double 
convex body, made up of concentric layers with a nucleus 
in the middle ; it also seems to be formed by three triangu- 
lar segments placed together. 

The arteries of the eyeball are the short ciliary, enter- 
ing around the optic nerve, and running to the middle layer 
of choroid and the ciliary processes ; the two long ciliary 



192 COMPEOT) OF ANATOMY. 

arteries, lying between the sclerotic and choroid, to supply 
the Ciliary muscle and the circumference of the iris and 
margin of the pupil ; the anterior ciliary branches from the 
ophthalmic, which enter the ball behind the margin of the 
cornea, to go to the ciliary processes and both margins of 
tbe iris ; and finally the central artery of the retina, which 
has already been described. 

The veins are formed from branches in the choroid, and 
piercing the sclerotic empty into the ophthalmic vein. 

The nerves of the eyeball are the optic, the long ciliary 
from the nasal nerve, and the short ciliary from the ciliary 
ganglion. 

APPENDAGES OF THE EYE. 

The eyebrows are elevations over each orbit, supplied 
with hairs. The eyelids, two in number, an upper and a lower, 
are movable curtains, or folds, to protect the front of the 
eye. The upper lid is the longer and more movable, and 
has a special muscle to lift it, the Elevator of the upper lid. 
The external angle where the lids meet is called the ex- 
ternal- canthus ; the internal angle is the inner canthus, but 
here the lids are separated by a little fossa, termed the lach- 
rymal lake. At the bottom of this lake is an eminence 
designated the lachrymal caruncle. On the edge of each 
lid, at the margin of the lake is seen a minute opening (punc- 
tum lachrymale), which is the beginning of a lachrymal 
canal. The eyelid is composed of a tarsal cartilage covered 
on the outside by the Orbicular muscle and skin, on the in- 
side by conjunctiva. Between the tarsal cartilage and con- 
junctiva lie the Meibomian glands, and on the edge of the 
lids are many short curved hairs, placed in two or three 
rows, named eyelashes (ciliae). The conjunctiva is a 
mucous membrane covering the inside of the lids (palpebral 
jDortion), and the front of the sclerotic and cornea (orbital 
portion). Upon the cornea the conjunctiva is very thin, 
and scarcely consists of more than an epithelial layer ; at 
the inner canthus it makes a semi-lunar fold (plica semi- 
lunaris). 

The lachrymal apparatus consists of the gland, canals, 
or canaliculi, sac and nasal duct. The lachrymal gland oc- 
cupies a depression in the frontal bone at the outer angle of 
the roof of the orbit, and opens by ducts upon the surface 
of the conjunctiva in the same region. At the inner can- 
thus the small orifices (puncta lachrytnalia), lead into minute 



EAR. 103 

tubes or canaliculi, which after making a sharp turn, open 
into the lachrymal s„c. This sac lies in a groove formed 
by the lachrymal bone and nasal process of the superior 
maxillary, and is really a dilatation of the upper end of the 
nasal duct. The duct is a canal three-quarters of an inch 
long leading through the superior maxillary b:me into the 
inferior meatus of the nose. It will thus be seen that the 
tears coming from the gland at the upper and outer angle 
of the optic commissure must pass over the surface of the 
eyeball before being discharged by the canaliculi and duct 
into the nose. 

EAR. 

The function of hearing resides in the ear, which consists 
of three parts : the external ear, the middle ear, and the in- 
ternal ear. 

The external ear is composed of the auricle, or pinna, 
and the external auditory meatus. The auricle is an ir- 
regular concave piece of cartilage, covered by integument 
and attached to the meatus. Near the meatus it presents a 
deep depression caller 1 the concha ; at its lower extremity is 
a non-cartilaginous portion, the lobule; the elevated edge 
or rim of the auricle is the helix, between which and the 
concha is another ridge called the anti-helix ; between 
these two elevations is the fossa of the helix ; while at the 
top of the anti-helix is a small depression, termed the fossa 
of the anti-helix. Below the opening of the meatus is a 
deep notch situated between two' small prominences; the 
anterior prominence is the tragus, the posterior one the 
anti-tragus, and the notch the intertragic fissure (incisura 
intertragica). 

The auricle or pinna is fastened to the skull by an ante- 
rior ligament extending to the zygoma, and a posterior one 
attached to the mastoid process. There are also two liga- 
ments holding the cartilage of the auricle together ; one from 
the tragus to the helix, the other from the concha to the 
anti-tragus. 

The muscles of the auricle are ot two kinds, those which 
attach it to the head and those extending from one part of 
the auricle to the other. The former, which move the 
auricle, have been described on page 57, the latter are un- 
important, but are named as. follows : — 

Great helicine, Anti-tragic. 

Small helicine, Transverse, 

Tragic. Oblique. 



194 COMPEND OF ANATOMY. 

The external auditory meatus, or auditory canal, is an 
inch and a quarter in length, is directed forwards and in- 
wards, and extends from the concha to the membrane of the 
tympanum, being formed by cartilage externally, and by 
bone at its inner extremity. The cartilaginous portion is 
half an inch, the bony part three quarters of an inch, long. 
The meatus is lined by thin integument supplied with hairs, 
and ceruminous glands which secrete the cerumen or ear- 
wax. 

The tympanum, or middle ear, is a cavity lined with 
mucous membrane, situated within the petrous portion of 
the temporal bone, communicating with the pharynx by the 
Eustachian tube, and traversed by a chain of ossicles, or 
small bones. These connect the membrane of the tympanum 
with the internal ear, and thus transmit vibrations from the 
membrane to the structures contained in the innermost por- 
tion of the organ of hearing. The tympanum is bounded 
above by a thin plate of bone separating it from the brain 
cavhty ; below it is separated from the jugular fossa by a bony 
layer ; externally its wall is the membrane of the tympanum 
and the circle of bone to which this is attached, while its 
internal wall is the partition between the middle and inter- 
nal ears. The posterior wall shows several apertures, the 
openings of the mastoid cells ; while the anterior wall pre- 
sents two orifices separated by a lamina of bone. The upper 
opening is the canal for the tendon of the Tensor of the 
tympanum muscle, the lower is the Eustachian tube leading 
down into the throat, while the bony septum is named the 
cochleariform process. 

The outer and inner walls of the tympanic cavity require 
further description. In the outer wall are seen three open- 
ings ; first the Glaserian fissure for the Laxator of the tym- 
panum and the graceful process (processus gracilis) of the 
malleus ; secondly, the posterior opening for the chorda 
tympani nerve coming from the seventh nerve (facial) in the 
aqueduct cf Fallopius ; and thirdly, the anterior opening 
for the exit of the chorda tympani, leaving the tympanum to 
go to the canal of Huguier. 

The membrane of the tympanum (membrana tympani), 
forming part of the outer wall, is a semi-transparent oval 
membrane, placed obliquely, so that it inclines downwards 
and inwards, and composed of three layers. The outer layer 
is tegumentary, like the lining of the meatus, the middle is 
fibrous and elastic, the internal is mucous and derived from 



EAR. 



195 



the lining of the tympanum. The handle of the hammer 
bone (malleus) is attached to the membrane of the tvm 
panum. J 

The points of importance to be noticed on the inner wall 
of the tympanum are three elevations and three opening 
The former are the ridge caused by the aqueduct of Fallo 

the S intPrn P a l 0m0nt0r J + d , Ue t0 the P/°i ecti °n of the cochlea of 
the internal ear and the pyramid which contains the Sta- 
pedius muscle; the openings are the oval window (fenestra 
ovahs) leading into the vestibule of the internal ear the 
round window (fenestra rotunda), situated below the oval 
window, opening into the cochlea and a small orifice at the 
top ofthe pyram>d,through which the tendon of the Stapedius 
passes. The oval window is closed by the base of 'the £ 
bone (stapes) and a delicate membrane; the round wmd ow 
brane U o P m Y * membra ne of teil called'the secondary mem" 
brane of the tympanum. This membrane is fibrous with a 
mucous surface towards the tympanum, a serous surface 
towards the external ear or labyrinth. 6 

Ossicles op the TTMPANUM.-The small bones of the ear 
crossing the tympanic cavity are three in number, and con- 

clos;n^ e tn?^ b , raDe / tlle ^ mpanU,n ™ th the naembrane 
mer £p„» « } l ™S The r are Called ma "eus, or ham- 

SteiheS hv rtT 1 *^ Stape !' - 0r StirrU P- The ha mmer * 
attached by the handle (manubrium) to the inner surface of 

wi hTh e e m bo r dv ne of tl the ^P*?™. and * tead articulate 
nerk *J tl & aUVl1 ' ° r lncus ' lt consists °f a head, 

neck, and three processes, called respectively the handle 
graceful process, and short process. The graceful process' 

„ J °, f ™ e tympanum, and passes into the Glaserian 
S!' !, shor P rocess hes at the base of the handle 
ofThV?vt e auu e m brane ' "* *» ™ M ^ * ^ ^ 

The anvil resembles a bicuspid tooth with two roots. The 
hammer articulates with the body of the anvil, where the 

shorted lour* W0U,Q h V , he fan ^ s of the tooth are he 
short and ong processes of the anvil, the latter of which 

oTorb cukrpV 1 " r r duI t e ' f en ™ ll * d the orbicular bone 
stirrup } ' articulates with the head of the 

wWlfw R T i r U t appr0 .P ri at3 name for the third bone, 

Sertion of thf ^ art ^ Ulatmg *?* h ^S anvi1 ' a neck for the 
insertion of the Stapedius muscle, and two branches joined 



196 OOMPEXD OF AX ATOMY. 

by the base, or foot piece, of the stirrup, which closes the 
oval window. 

Ligaments and muscles- op the ossicles. — These little 
bones are held together, so as to be movable, by capsular 
ligaments ; and are attached to the walls of the tympanum 
by the suspensory ligament of the hammer, suspensory liga- 
ment of the anvil, posterior ligament of the anvil, and annu- 
lar ligament of the stirrup which fastens the foot piece of 
this bone to the circumference of the oval window. The 
muscles moving the ossicles of the ear are : — 

Tensor of tympanum, from lower surface of petrous bone 
to short process of hammer, to make membrane 
tense. It enters tympanum by canal above 
Eustachian tube. 

Laxator of tympanum, from spinous process of sphenoid 
to neck of hammer, to relax the membrane. It 
enters by Glaserian fissure. 

Stapedius, from interior of pyramid to neck of stirrup ; it 
probably compresses the fluid in the vestibule. 

All the structures within the tympanum as well as its walls 
are covered by mucous membrane, which is continuous with 
that of the throat, through the Eustachian tube, and also 
with that lining the mastoid cells. 

The internal ear or labyrinth is the portion of the organ 
of hearing to which the fibrils of the auditory nerve are dis- 
tributed ; while the external and middle portions of the ear 
are simply the conducting apparatus, which brings the vi- 
brations of sound to the sensitive nerve filaments spread out 
upon the surface of the inner-ear. The internal ear is 
divisible into the vestibule, semicircular canals and cochlea, 
which are irregular cavitie3 within the substance of the pe- 
trous bone. Within these cavities lies a membranous sac, 
corresponding in shape with the bony vestibule, semicircular 
canals and cochlea, named the membranous labyrinth. Be- 
tween the membranous and bony labyrinths is a serous fluid 
called perilymph, and within the membranous labyrinth is a 
similar fluid, the endolymph. 

The vestibule connects the canals and cochlea, and com- 
municates with the tympanum or middle ear. It lies internal 
to the tympanum and between the cochlea and semicircular 
canals • the cochlea is in front of, and the canals behind, it. 
In the outer wall of the vestibule is the oval window com- 
municating* with the tympanum, but closed by the stirrup 
bone : while upon the surface of the inner wall is seen the 



EAR. 137 

orifice of \lie aqueduct of the vestibule, transmitting a vein 
from the posterior surface of the petrous bone. In the roof 
of the vestibule are the five openings of the semicircular 
canals, and the large passage way of communication with 
that part of the cochlea called the staircase of the vestibule 
(scala vestibuli). On the roof and inner wall are numerous 
small orifices occupied by filaments of the auditory nerve. 

The semicircular canals are three channels, each forming 
two-thirds of a circle, presenting at each end, before open- 
ing into the vestibule, a dilatation (ampulla). The superior 
and posterior canals are vertical, but at right angles to each 
other ; the external one is horizontal. 

The cochlea resembles a snail shell, being a tube wound 
spirally around an axis or modiolus. From the base to apex 
it makes two turns and a half, and its base presents towards 
the internal auditory meatus, while the apex points out- 
wards and forwards. The canal of the cochlea is divided 
into two staircases (scalse) by a partition designated the 
spiral lamina j at the apex of the cochlea the staircases 
communicate by an opening called the helicotrema. Through 
the axis or modiolus nerve filaments pass, to be distributed 
to the staircases and spiral lamina between them. The 
lower staircase, named the staircase of the tympanum (scala 
tympani), communicates by the round window with the 
cavity of the tympanum, and here is, in fact, its beginning. 
The upper, or staircase of the vestibule (scala vestibuli), 
commences at an opening leading int3 the cavity of the 
vestibule. 

The c.cinal of the cochlea has been described as divided 
into two staircases by the spiral lamina. This bony lamina, 
however, does not extend completely across from the mod - 
olus, or axis, to the outer wall of the canal, but from its edge 
to the wall stretches the basilar membrane (membrana basil- 
aris). From near the base of the spiral lamina above, another 
membrane, termed the membrane of Reissner, extends 
across to the outer wall ; and between the basilar membrane 
and the membrane of Reissner a third membrane stretches 
across, called the membrane of Corti (membrana tectoria). 
The space below the osseous spiral lamina and the basilar 
membrane is the staircase of the tympanum, that above the 
bony spiral lamina and the membrane of Reissner is the 
staircase of the vestibule, while the interval between the 
basilnr membrane and Reissner' s membrane is the middle 
staircase (scala media). Along the upper surfaeo of the 



198 OOMPEXD OF ANATOMY. 

basilar membrane lies the organ of Corti, consisting of a 
series of arches and epithelial cells. The organ of Corti is 
supposed to be the terminal apparatus of hearing, similar to 
the retina in the eye, and nerve filaments which enter the 
cochlea probably terminate in the organ of Corti. 

The bony labyrinth, or internal ear, is lined by a serous 
membrane, which secretes the perilymph or fluid of Cotun- 
nius. 

The membranous labyrinth is a closed sac resembling the 
bony labyrinth in a general way, and contains the endo- 
lymph. Its vestibular portion lies in the bony vestibule, but 
ic much smaller and consists of two portions, the saccule and 
the utricle, which appear to have no orifice of communica- 
tion. In the walls of the utricle and saccule are found cal- 
careous particles called otoliths. The membranous semi- 
circular canals are like the bony canals, but smaller- The 
membranous portion of the Cochlea is the middle staircase 
previously described. Upon the surface of the mem'branous 
labyrinth the filaments of the auditory nerve are found. 

THE END. 



JUST ISSUED. 
THIRD EDITION. 

THE COMPEND OF ANATOMY. 

FOE USE IN THE DISSECTIM* ROOM 

AND IN 

PREPARING FOR EXAMINATIONS. 

BY JOHN B. ROBERTS, A.M., M.D., 

Lecturer on Anatomy and on Operative Surgery in the Philadelphia School 

of Anatomy ; Demonstrator of Anatomy in the Philadelphia Dental 

College ; Recorder of the Philadelphia Academy of Surgery. 



OPINIONS OF THE MEDICAL PRESS. 

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* # # * w e recommend the volume to students." — Medical and Surgical 
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16mo, pp. 198. 



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THE PRACTICE OF SURGERY, 

By THOMAS BRYANT, F.R.C.S., 

Surgeon to Guy's Hospital, etc. 

THIRD EDITION, 

Edited and Enlarged for the Use of the American Student and Practitioner, 
By JOHN B. ROBERTS, A.M., M.D., 

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In one large and very handsome imperial octavo volume of 1005 pages, with 
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RECENTLY I> XT ELI SHE 33. 

Paracentesis of the Pericardium-, 

A Consideration of the Surgical Treatment of Pericardial Effusions. 

By JOHN B. ROBERTS, A.M., M.D., 

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With Illustrations. Svo, pp. IOO. Extra Cloth. $1.25. 



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